Adoption Application for Dogs

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Thank you for your interest in adopting from the Surrey Animal Resource Centre. If you have any questions or concerns about any part of this form, please let us know! Adopters must be over 19 years old. We reserve the right to refuse this application.

Date*

Animal Name:*

Animal #:*

Contact Information

First Name:*

Last Name:*

Unit # / Address:*

City:*

Province:*

Postal Code*

Phone Number:*

Email:*

About Me

How long have you been thinking of welcoming a new pet into your home?*

What do you feel are the most important responsibilities in owning a dog?*

Have you ever surrendered a pet to a shelter or other organization in the past?*

Please indicate reasons:

Have you made arrangements to spend a few days with the dog as it becomes accustomed to its new environment?*

Comments:

About My Home

Number of adults in the household?*

Number of children?*

Ages?

Are any family members allergic to dogs?*

Yes
No
Unsure

Are there regular visitors to your home, human or animal, which your new dog must get along?*

Please describe:

Do you live in a:*

House
Townhouse
Apartment
Trailer
Condo
Other - please specify:

Do you own or rent?*

Own
Rent

Do you have landlord's permission to keep a dog?*

Landlord's Name: (First & Last)*

Phone #:*

How long have you lived at this address?*

Do you have a fenced yard?*

If no fence, how will you handle dog’s exercise and toilet duties?

Fence height:*

Fence type:*

Information we collect and why we collect it.

Personal information is collected for the purpose of adopting an animal. The City of Surrey is collecting this information under s. 26 (c) of the Freedom of Information and Protection of Privacy Act. For questions regarding the collection of personal information, please contact the Surrey Animal Resource Centre Manager, 17944 Colebrook Road Surrey, 604-574-6625.

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