Adoption Questionnaire Want to adopt from us? Fill in the form below and we will be in touch as soon as we can to arrange a viewing What pet are you interested in?*Name* First Last Address* Street Address Address Line 2 City County / State / Region Post Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Phone*Email Current PetsHave you had pets before?*Only when younger with parents/guardian.Yes - Please state below your pets.Not owned a pet before.What kind of pet/s?*What happened to them?*What pets do you have now?*Please provide as much information as possible including, type, age, if they are neutered and vaccinated.Where are your pets kept during the day / night?*Vets Used*Which Veterinary Practice do you use?About Your FamilyHow many Adults live at home?*How many Children live at home and what are they ages?*Do you have any children visiting? If so what are their ages?*Do all Adults in your home consent to having a new pet?* Yes No Are you or any family member allergic to pets?*Is someone home most of the day?*If you work, will your hours be changing soon or in the near future?*Are you planning on getting a new job soon or in the near future?*Are you planning a holiday soon or in the near future?*Are you planning a family soon or in the near future?*About Your HomeIs your home ...*OwnedRentedHave you had permission from your Landlord? Also, to add to the number of pets you currently care for? If so, before we can take your application further, we will need confirmation, either a letter or email from your landlord stating this.*YesNoIs your home a ...*FlatHouseHow long have you lived here?*Do you have a Yard or Garden?*YesNoIs it fully enclosed?*YesNoDoes it have fencing or a wall over 6ft high?*YesNoIs your garden for your use only or shared?*Yes - It's for my use onlyNo - It's a communal garden/sharedThe cost of owning a pet includes many things not just food. Boarding Kennels & catteries cost around £7 per night and require that your pets vaccinations are up to date. Are YOU prepared to pay vet bills when required or if you are unwaged and on certain benefits with help from the PDSA. Remember Vet consultations can be around £20 and that's before the cost of the medication is added on. Pets can live a long time ie Dogs and Cats can live to over 15 years and Rabbits up to 9 yearsHave you considered the cost above costs of owning a pet?*YesNo Please be aware that we reserve the right to charge a delivery fee if you live outside of the Liverpool area for Mileage including a Tunnel Fee is applicable. We also reserve the right, at any stage to decline the offer of a home for one our animals. We sometimes have lots of applications for the same animal and we will choose the most suitable home.