ADOPT HERE! | South Derbyshire Wildlife and Animal Rescue

Name / ID of the animal you wish to adopt: *

Full name: *

Email address *

Full address (inc postcode) *

Phone number: *

Date of birth: *

Do you have any special requirements that may require us to make adjustments to our processes? *

Have you ever been convicted of an animal cruelty offence or been banned from keeping animals? (If so, please give details.) *

Do you have any other pets? *

Do you have any kids, if so, what ages? *

Do you have permission to have pets at your house? *

Yes, I own my home.
Yes, I have permission from my landlord.
No, I do not have permission.

Do you expect a change in your circumstances? (Having a baby, starting/ending employment, moving house, holidays, etc) *

Do you have a secure, private garden? *

Have you owned an animal of this species before? *

Do you consent to us storing your data and contacting you in regards to this application? *

Please briefly explain your circumstances and include anything else you feel we may need to know to make a decision: *

Please be aware that Homechecks apply to all adoptions, and that before finalising the adoption we will request a form of photograph ID. All adoptions are subject to our terms and conditions which can be seen below.

I agree to the above and confirm that all information shared is accurate to the best of my knowledge, I understand that failing to disclose information regarding this application may lead to this and future applications being automatically refused. *

I agree

Terms And Conditions Of Adoption V1.3

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