Ruff Start Rescue Application Form

Application Form

Please fill out each section
PLEASE READ

Before continuing please be aware of the following;

*WE DO NOT HOME TO FAMILIES WITH CHILDREN UNDER 3 YEARS OLD

*IN FAMILIES WHERE CHILDREN ARE AGED 3-5 WE WILL ONLY ALLOW ADOPTION OF PUPPIES UNDER 6 MONTHS

*IN FAMILIES WHERE CHILDREN ARE BETWEEN THE AGES OF 5-8 THERE MUST BE A RESIDENT DOG IN THE HOME OR RESIDENT DOG RECENTLY PASSED AWAY

*ANY CHILD WITHIN THE HOME WHO HAS A DIAGNOSIS OF (OR UNDER INVESTIGATION FOR / SUSPICION OF) LEARNING OR EDUCATIONAL NEEDS OR IS ON THE AUTISM SPECTRUM WE WILL ONLY ALLOW REHOMING WITH SEVERAL PRE ARRANGED MEET AND GREET APPOINTMENTS WHERE THE CHILD IS PRESENT

*ANY PUPPIES WILL ONLY TRAVEL AFTER THE AGE OF 16 WEEKS

*WE DO NOT HOME TO FAMILIES WITH CHILDREN IN FLATS ABOVE FIRST FLOOR

*WE DO NOT HOME LARGE DOGS TO ANY APPLICANTS IN FLATS

*IF YOU ARE APPLYING TO ADOPT A PUPPY - PLEASE BE AWARE THAT YOU MAY BE PLACED ON A WAITING LIST

*OUR REHOMING DONATION IS £500 IN THE UK AND €400 IN EUROPE

Before travel Ruff Start Rescue CIC ™ have all their dogs tested for;

Heartworm,

Lyme disease,

Ehrlichia canis,

Ehrlichia ewingi,

Anaplasma phagocytophilum

Anaplasma platys

Lungworm

Brucellosis

Leishmaniasis
Name

First NameLast Name
Date of Birth
E-mail
Address
Postcode
Phone Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
Please check this box to proceed*
If your application is NOT dog related please state here (I.e cat) but continue to complete the rest of the form - answering the questions with the type/breed of animal in mind you are applying about.
Are you applying to foster or adopt?
Have you seen a dog you are interested in? If so please fill in their name
If you have not yet seen a dog - are you looking for;

A puppyAn old dogA small dogOpen to anything
Have you been speaking to a member of our team? If so please provide their name
If adopting - are you happy for us to reserve this dog to you now? (Please note non-refundable reservation deposit of £50 for adoptive dogs is only payable on confirmation of successful homecheck.)
IS YOUR GARDEN SECURELY FENCED TO A HEIGHT OF 5-6 FEET - IF NOT WOULD YOU BE ABLE / WILLING TO RECTIFY THIS;
PLEASE TELL US ABOUT ALL OTHERS WHO LIVE IN YOUR HOME - THEIR AGES AND OCCUPATIONS
DOES ANY MEMBER OF YOUR HOUSEHOLD HAVE ANY DISABILITY - PHYSICAL/MENTAL OR EDUCATIONAL?
DO YOU HAVE ANY RESIDENT PETS CURRENTLY? ARE THEY ALL NEUTERED/SPAYED?
Are you currently employed?

YesNo
What is your job title?
If you do work, what plan do you have for the dog whilst at work?
ARE YOU ABLE TO PROVIDE A PLACE OF SAFETY AND CALM FOR YOUR NEW DOG AWAY FROM CHILDREN/VISITORS/RESIDENT PETS;
ARE YOU ABLE TO SEPARATE YOUR NEW DOG FROM ANY RESIDENT PETS AND WILLING TO WORK WITH A LONG LEAD UNTIL A SUITABLE LEVEL OF TRAINING IS REACHED;
DO YOU UNDERSTAND THAT YOUR NEW DOG MAY TAKE TIME TO SETTLE, SHOW SIGNS OF FEAR SUCH AS GROWLING AND BARKING, THAT THIS WILL BE A TEMPORARY REACTION AND THAT YOU SHOULD ALLOW YOUR DOG TIME AND SPACE - HOW WOULD YOU DEAL WITH THIS SITUATION;
PLEASE TELL US ABOUT YOUR PREVIOUS DOG OWNERSHIP EXPERIENCE INCLUDING ANY DIFFICULTIES YOU HAVE ENCOUNTERED IN THE PAST;
WOULD YOU HANDBACK YOUR DOG FOR ANY OF THE FOLLOWING REASONS;
WOULD YOU BE WILLING TO ACCEPT ADVICE AND WORK THROUGH ANY OF THE ABOVE ISSUES IF THEY WERE TO OCCUR;
HAVE YOU EVER HANDED BACK OR REHOMED A PET - IF SO PLEASE TELL US THE FULL CIRCUMSTANCES SURROUNDING THIS;
DETAILS OF VETERINARY SURGERY WITH WHOM YOU ARE REGISTERED OR INTEND TO REGISTER;
TERMS AND CONDITIONS

BY COMPLETING AND SIGNING THIS FORM, I AGREE TO THE USE OF MY INFORMATION BY RUFF START TO ARRANGE A HOME CHECK TO ASSESS MY SUITABILITY AND ALSO TO PASS MY INFORMATION TO ANY THIRD PARTY ONLY FOR THE PURPOSE OF TRANSPORTATION OF ANY DOG I FOSTER OR REHOME. I CONFIRM I WILL READ THE INFORMATION SHEET PROVIDED IN EMAIL (UPON SUBMISSION OF THIS FORM) BY RUFF START RESCUE CIC. SHOULD ANY DOG I FOSTER OR REHOME THROUGH RUFF START BE LOST DUE TO LACK OF DUE CARE ON MY PART I ACCEPT I AM LIABLE FOR THE COST OF RECOVERY OF THE DOG TO SAFETY.I AGREE TO ANSWER ALL QUESTIONS HONESTLY AND THROUGHLY, AND THAT FAILURE TO DO SO MAY RESULT IN MY APPLICATION BEING REJECTED. I AM AWARE THAT RUFF START MAY CONTACT MY VETERINARY PRACTICE FOR A THIRD PARTY REFERENCE IF NEEDED. I UNDERSTAND THAT IF I AM ADOPTING A NON REFUNDABLE DEPOSIT OF £50 IS DUE UPON COMPLETION AND SUCCESFUL PASSING OF MY HOMECHECK AND THAT THE BALANCE OF THE REHOMING DONATION IS DUE EITHER ON COLLECTION OR 48 HOURS PRIOR TO COLLECTION.
PLEASE NOTE WE ARE A SMALL TEAM AND IT MAY TAKE UP TO 10 DAYS FOR US TO WORK THROUGH APPLICATIONS DURING BUSY PERIODS AND GET BACK TO YOU - IF YOU HAVE ANY QUESTIONS OR ARE CONCERNED YOU HAVE NOT HEARD PLEASE DO CONTACT US ON admin@ruffstartrescue.co.uk
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Ruff Start Rescue CIC

C/O Talafon, Llanerfyl, Welshpool, Powys SY21 0EJ

07943 566065
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Application Form

TERMS AND CONDITIONS