Register Your Interest

Full Name *

Full Address *

City *

Eircode *

Email *

Mobile Number *

Date of Birth *

Alternative Full Name *

Alternative Contact Number *

How many Adults at home? *

How many Children at home? *

Please list ages of children * (Please note if ages do not fit with age suitability required for this dog your application unfortunately will not be accepted and we will not be in touch)

Please list ages of visiting children *

Do you live in a House or Apartment? * House Apartment

Does any individual in your home have any special requirements? * Yes No

Are you: * House Owner Renting Living with Parents

If renting do you have permission to have a dog in the home? * Select an Option Yes Pending

Does any individual have allergies or asthma? * Yes No

Have you applied for a dog from the DSPCA before. * Yes No

Do you have an existing dog? * Select an Option Yes No

Sex of the Dog * Select an Option Female Male

What breed is your dog? *

Is your dog neutered? * Yes No

Do you have any other pets? * Yes No

If Yes, provide details *

Have you owned a dog before? * Select an Option Yes No

If yes, what breed was it? *

What type of dog are you looking for * Please give rough outline

Who was helping you with your application? * Select an Option No one - Online Only Amy Edyn Emma Kate Tanya Valerie Volunteer Liaison

Where would you like your dog to sleep at night? *

Please upload photo(s) of general area of where you would like you dog to sleep. (2 pictures at least. Online Images) *

Do you work full time? * Yes No

What is your occupation? *

Will you be going back to full time work after Covid -19? * Yes No

How many hours will your dog left alone during the day when you go back to work *

Is all the family in agreement with adopting a dog? * Yes No

Do you have a secure garden? * Select an Option Yes No

Please upload photo(s) of your garden showing any walls/side gates. * (If your application is successful this will help to speed up the adoption process)

Is your garden Walled, fenced, hedged? *

Do you agree to a home check? * Yes No

Do you agree to neuter your dog? * Yes No

Are you planning any of the following: Holidays, Moving house, Children * No Planning Holidays Moving House Children

If Yes, please provide details of when you are ready and available to adopt a dog. * i.e. Ready to adopt now, not available until the end of the month, etc.

Are you willing to attend training classed if advised to do so? * Yes No

When you are not at home, where do you plan to leave your dog? *

I consent to the *DSPCA contacting me about their Organised Events, Activities and Services. Yes No

I understand and accept that the Adoption Fee per dog is €185 should we be chosen to adopt. *

Neutering Appointments: Your contact details will be given directly to our partners Village Vets in order to make an online neutering appointment for your adopted dog. Please tick the box if you consent to this. *

Home checks will be carried out at random after the adoption. Please tick the box if you consent to this. *

I have read and understand all of the above *

'DSPCA' refers to The Dublin Society for Prevention of Cruelty to Animals and its wholly owned subsidiary DSPCA Animal Shelter . Please check the web site www.dspca.ie for our Data Protection Privacy Statement.