Adoption Form

To apply to rehome one of our animals, please complete the below form fully and honestly and submit. We will then be in touch to discuss moving forward with your application.

Only applications that are fully completed will be considered. Your application will have been successfully submitted when you see ‘The form was sent successfully’ at the bottom of the form below the submit button.

Please note, we receive a large volume of applications so please bear with us – we will contact as soon as we can.

Title

First Name

Surname

Address

City

County

Postcode

Email Address

Contact Number

I am interested in adopting

Dog Puppy Cat Kitten Rabbit Guinea pig Other small animal

Preferred Gender

Male Female No Specific Requirement

Age

0-6 months 6-12 months 1-4 years 4 years + No preference

If you have seen an animal on our website, please tell us the name

Have you ever adopted or fostered an animal from Assisi Animal Sanctuary

Yes No

Do you own (or have you previously) owned any animals

Yes No

If Yes, are they Neutered/Spayed

Yes No

Vaccinated

Yes No

Do you have children?

Yes No

If Yes, what ages are they?

Do you own or rent your home?

Own Rent

If you rent, please provide landlord's details

Do you have a garden?

Yes No

Is it Secure?

Yes No

Where will you keep the animal at night?

Will the animal be alone during the day?

If Yes – for how long?

Have you ever surrendered a pet before?

Yes No

If Yes – please explain why?

Where did you hear about us?

Website Facebook Instagram Word of Mouth Newspaper

Other

Consent Options

Post Phone Text Email

We will always keep your details safe and will never share them with any other organisations without your prior consent. You can change your contact preferences at any time.

Please tick here if you are happy for us to hold your details on file for future potential suitable animals.

Please tick to confirm you are 18 years or over

Signature

Date