Perfect Match Form

Are you interested in:
AdoptionFostering

Which dog / puppy on the website are you interested in?

How did you hear about us?
—Please choose an option—Already knew ShelterWord of mouthReferred from elsewhereRSPCA websiteLittle Valley websiteSocial mediaOther

1. Your Details

Title
—Please choose an option—MrMrsMsMissDrProfessor

First Name

Surname

Email

Telephone

Address

Postcode

2. Your Home

Do you own your own home?
YesNo

Do you rent your home?
YesNo

If you rent, have you got written permission from your landlord?
YesNo

Do you have a secure garden?
YesNo

Is it communal?
YesNo

Number of adults living at home:

Number of children:

Children's ages:

Any visiting children?
YesNo

If yes, ages:

Are there any other dogs at your home?
YesNo

If yes, how many:

Gender
MaleFemale

Are they neutered?
YesNo

Have they been vaccinated in the last 12 months?
YesNo

Are there any other animals at home?
YesNo

If yes, please state what they are and how many:

3. Your Lifestyle

Amount of daily exercise you expect to give the dog – weekday hours?

Weekend hours?

How long do you expect to leave the dog alone on a regular basis – hours per day:

How often will this be:

Are you planning to move home in the next 6 months?
YesNo
Do you have any holidays planned in the next 3 months?
YesNo

4. Your Ideal Dog

Size of dog:
—Please choose an option—Small (e.g. Terrier)Medium (e.g. Staffie)Large (e.g. Labrador)Any

Age of dog:
—Please choose an option—Puppy1-2 years2-5 years5-8 years8+ yearsAny

Gender of dog:
MaleFemaleEither

Please check which of these are important to you:

Good with cats:
Very importantQuite importantNot important

Likes other dogs:
Very importantQuite importantNot important

Good with livestock:
Very importantQuite importantNot important

Comfortable around children:
Very importantQuite importantNot important

Likes strangers:
Very importantQuite importantNot important

Housetrained:
Very importantQuite importantNot important

Likes travelling in a car:
Very importantQuite importantNot important

5. Your Experience With Dogs
Please tell us about your experience with dogs

Do you confirm that all the above information is true and accurate and that you agree to the RSPCA Adoption/ Fostering processes and are happy to have a home visit if required?

I confirm

YOUR INFORMATION