(*indicates mandatory fields)

First Name:*
Surname:*
Phone Number:*
Email Address:*
Suburb/State:*
Are you 18 years of age or older?*YESNO
Is there a particular dog you are interested in?*YESNO

Please tell us a bit about yourself and the home/lifestyle you could offer an NQAR dog. This will help us determine your potential suitability for the particular dog you are interested in, or if making a general enquiry this will help us to suggest a dog that might be a good fit.

Why are you interested in adopting a dog (i.e.companionship for yourself or another pet, guard dog, potential therapy dog, exercise buddy, etc)?*
Who else lives in your household including any children and their ages.*
Do you have any other pets? Please list how many and what type. For dogs, please advise male/female, age and breed.*
Do you have a fenced yard? Please describe the fencing.*
How many hours on average would the dog be left alone (without humans) each day.*
If enquiring about a specific dog, do you have experience with its breed?*
Please describe your general activity level and the energy levels you are looking for in a dog.*
Please provide any other information re your lifestyle and what you are looking for in a dog.*