Adoption Application "*" indicates required fields Step 1 of 5 20% Name* First Last Phone*Email* Enter Email Confirm Email Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Preferred Size Small Medium Large Select AllPreferred Age 3-6 Months 6-12 Months Adult Senior 8+ Select AllPreferred Coat Short Medium Long Low Allergy Select AllWhich personality traits do you want your cat to have?What would type of pet would you adopt Cat Dog I would consider adoping multiple pets Yes No I would consder adopting a special needs pet Yes No New Cat housing Indoor Only Indorr + Enclosure (day only) We recommend cats are always kept inside or ONLY let out into a fully secure outside area during the day, ONLY where it is not too hot or cold. Cats are vulnerable to cars, people, other cats, dogs and many diseases when allowed to roam, often cause of injury and death. Outside cats live around 3-4 years shorter lives than indoor catsNew Dog Housing Indoor mostly Indoors 9-5 work days In/Out whenever they like We recommend dogs are kept indoors at night, for safety. Trees are not sufficient shelter for a dog. Dogs need appropriate shelter from the weather. Dog Shelter Carport Garage Laundry Kennel Other(details) Select AllOther details Your Property Details House Unit Town Rural Farm Other Tell use about your living situation, do you Own Rent Board How many months have you lived in your current accomodation? Rental Agent/Body Corporate Approval Please be aware many rental properties do not allow pets. If they do, this usually requires prior written approval from the agent or landlord. * If you are renting or boarding you must also complete the CPRR Pet Approval Form link here Your outdoor areas Yes No N/A Are any gates able to be locked? Yes No N/A Do you have a pool/pond/spa? And is it securely fenced? Yes No N/A Height and type of fencing How busy is your street? Quiet Moderately busy Very Busy - High Traffic Current Pets Yes No Past Pets Yes No Tell us about your other pets. Breed temperament, age?Other pets desexed? Yes No Are all your existing pets vaccinations, flea control and worming up to date? Yes No If you have owned a pet that you do not have now, how long did you have them, and what happened Number of Adults in your domicile?Number of Children in your domicile?Age of youngest child?Is everyone supportive of adopting a new pet Yes No Unsure Is anyone allergic to dog/cat or animal fur? Yes No Unsure Do you want to adopt a pet as a companion for Myself My cat My dog Child / Children Other Will you have problems with neighbours? Yes No Unsure Do your neighbours have pets? No Yes - Confined Yes - Not Confined Yes - Unsure of confinement Do you feel confident looking after a new pet? Yes No I'd like some advice Do you have time to look after a new pet? Yes No I'd like some advice Would you be prepared to house train your dog if needed? Some dogs may need help learning how to live "Inside" which can mean lots of cleaning and pateince? Yes No I'd like some advice How many hours could you spend walking your dog a week?Would you be prepared to access professional training for your dog if needed Yes No What would you do if your pet was found to suffer from behavioural problems? Surrender to pound Access Training Consult Behaviourist Ask CPRR for help Would you consider pet insurance Yes No I'd like some advice Even minor injuries can result in some significant veterinary costs. What would you do with your pet during holidays? Please tell us if you or anyone in your household have any health or medical conditions which would affect your ability to care for a dog?Have you or anyone in your household been convicted of a criminal offence? Yes No Unsure Have your or anyone in your household been convicted of animal cruelty, animal neglect, or had an animal removed from your care? Yes No Unsure Please provide detailsReference 1 - Full Name Reference 2 - Full Name Reference 1 - Phone or Email Reference 2 - Phone or Email Reference 1 - Full Address Reference 2 - Full Address Reference 1 - Relationship to you Reference 2 - Relationship to you To assist with your application, please include three or four photographs of the areas you would have your dog live in. Include outdoor enclosed space if that is the plan. Please note that a representative from CPRR may need to inspect your property prior to adoption to ensure the safety of the animal you are adopting.* Drop files here or Select files Accepted file types: jpg, png, Max. file size: 5 MB, Max. files: 4. Other - Please write any other comments or information which you believe may assist us with your applicationADOPTION Terms and Conditions* By checking this box I acknowledge I have read, understand and agree to these "Adoption Terms and Conditions" shown above. All information supplied is true and correct and is not misleading in any way. I have not omitted any answer that would be considered misleading by omission.All adoptions are subject to a site inspection to confirm a suitable home. After the site inspection, a two week trial period is offered to ensure a safe and suitable match of the dog with its new home. Half the adoption fee must be paid prior to the start of the two week trial period. (Refundable if adoption does not go ahead). To complete the adoption process, remainder of payment and an Adoption Agreement and Transfer of Ownership must be completed. Puppies and Kittens who are adopted before they are old enough to be desexed, are done so with the understanding you will have them desexed as soon as they are age appropriate. An Adoption Application (this document) is an expression of an interest to adopt a dog. Completion of this document does not guarantee approval to adopt. An Adoption Application (this document) may be referred to the CPRR team for consideration. Decisions on Adoption Applications are based solely on an assessment of the applicant's capacity and commitment to provide a safe, loving and permanent home for the dog under consideration. With this in mind, the CPRR Assessment of Dog Adoption Applications is final. Declaration and Signature I acknowledge that a dog may live for 10 to 20 years and I am willing and able to meet the costs that are likely to be necessary to care for my animal including: ongoing costs of food, yearly vaccinations, regular flea and worm treatments over its lifetime. If my animal needs veterinary care I am willing and able to meet those costs. I will welcome my dog as a member of my family and provide a secure, permanent and safe loving home. I have the physical and financial capacity to include a dog within my family and I will be able to maintain a good standard of care. I will never re-home, sell or surrender my dog to a pound or animal shelter. I intend to provide a 'fur-ever' home, however should my circumstances change and I am unable to keep my dog, I am aware of my obligation to contact CPRR and return my dog to them. I confirm I am over 18 years of age and if I am in rental accommodation, I have proven I have Strata and Landlord or Agent’s permission to have a dog at the premises. I acknowledge and accept that animal behaviour can change and be unpredictable. I acknowledge and accept that while CPRR will be fully upfront about any potential issues they are aware of, they will not be liable for any injuries, attacks or damages caused by the dog after it comes into my care.CommentsThis field is for validation purposes and should be left unchanged.