Cage-to-Cape Town Adoption Application #FromCageToCapeTown Dog Adoption Application Thank you for opting to adopt your best friend. DOG’S DETAILSAdoption confirmation* Completing this form means you are currently looking to adopt one of the FABULOUS FIVE #FromCageToCapeTown dogs and are willing to have a home inspection.Please confirm which dog/s you want to adopt*Insert name hereAPPLICANT’S DETAILSName and surname*Your age*Under 1818-2425-3435-4445-5455-6465-7575+Physical Address* Address Line 1 Address Line 2 City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact number*Additional contact number*Email* TEARS Newsletter Puppies and kittens in my inbox? Yes, please! I’d love to receive the TEARS Tails Newsletter! FOUR PAWS Newsletter Subscribe to our newsletter informing you about our work every month! Is your home a free standing house, apartment or complex?* Free standing house Apartment/flat Complex Small holding Other To what extent is your property secured? Please describe the height and type of your perimeter boundary and gates.*Do you own or rent your home? If you rent, do you have permission to keep pets?* Home owner Rent, have landlord’s permission Rent, need to ask for landlord’s permission Are there any restrictions to take into account, for example: size, breed, number of pets per household, etc?Where on your property are pets not allowed?*Do you have a swimming pool or large pond?*No swimming pool or pondYes, enclosed swimming pool or pondYes, covered swimming pool or pondYes, not covered or enclosedHow many hours a day will the dog be alone without human supervision?*1 – 3 hours4 – 6 hours7 – 9 hours9+ hoursPlease list everyone living on your property, inclusive of children and staff:*NameAgeRelation to youAffinity with dogs Click on the + button to add another personDo children (12 years and younger) visit your home?*Yes, children frequently visit my homeYes, children occasionally visit my homeNo, children rarely visit my homeWhat is your dog experience?* First time dog owner Have had one or two dogs Have had many dogs Volunteered at an animal shelter Have attended dog training classes Will you be willing to take your new family member to puppy school/dog training classes? Yes, all puppies need to go to Puppy School No, I will train my own puppy at home Happy to go to Dog School with my new dog No, would like a dog who needs minimal training Why do you want to adopt a dog?* Family pet Companion for yourself Companion for your kids Companion for your other pets Sport/agility Guard dog Hunting Breeding Other Other:Do you currently own any pets (dogs, cats, rabbits, etc)?*YesNoPets currently living with you:*Pet's nameAgeGenderSpecies and breedIs this pet kept inside, outside or both?Sterilised? If not, please explain why:How does this pet get along with new dogs? Click on the + button to add another petWhere will your dog spend most of the time during the day?*Where will the dog sleep at night?*How often would you take the dog for walks?*Where would you take the dog for walks?*Have you ever surrendered a pet to a shelter?*NoYesPlease explain why:*Have you ever had a pet euthanased?*NoYesPlease explain why:*Are you willing to take responsibility for a new dog for the next 10 – 15 years?*YesNoIf your circumstances were to change (emigration, downsizing, starting a family, financial difficulty), what provisions would you make, or already have in place, for your pets?Are you able to afford private veterinary care for your existing pets and a new addition?*YesNoAre you financially prepared for a new pet?*YesNoTaking on a new pet can be expensive, costing anywhere from R500+ a month.Would you be interested in finding out more about pet insurance?*YesNoJust like medical insurance for humans, pet insurance protects your furry family members and your bank balance. Go to the vet with peace of mind knowing you’ll be reimbursed within 48 hours for vet bills resulting from accidents, health scares, check-ups, and more.Veterinary Practice* Name of practice Contact number Is there anything else you would like to sharePLEASE NOTE TEARS will manage the Adoption Application and Home Check in consultation with FOUR PAWS to ensure that each dog is placed with the most appropriate pet parents/s. The selection process will be overseen by TEARS in consulation with FOUR PAWS and the final decision will be based on what we consider to be in the best interest of the animals.
