Adoption Application Form

ADOPTION APPLICATION FORM

Kindly email completed application form to [email protected]

PLEASE TAKE NOTE: On written confirmation of Adoption (“Confirmation of Adoption Date”), notwithstanding the fact that the dog may still be in foster kennels and/or with its present owner, the Applicant shall be liable for any and all veterinary expenses from the Confirmation of Adoption Date up and until the dog arrives at the Applicant’s home, and forever thereafter.

PLEASE TAKE FURTHER NOTE THAT: Should any provision and/or condition and/or term of this Agreement be breached by the Applicant, GSP Rescue SA has the right in its sole discretion to confiscate the adopted animal.

ADOPTION APPLICATION

We make absolutely no apologies for the length of this form (often we sort the “men from the boys” as we are incredibly grateful to the great many forever homes where we have placed dogs for bearing with us in the adoption process). We consider that adopting a dog is to be viewed in the same serious light as adopting a human child. Please spare a thought for the often forgotten dogs that later land up in shelters and join the over 1 million dogs that are euthanased in South African shelters each year. Seriously consider adopting one of them. The adoption application form and contract HAVE to be completed in full (if not completed in full, we will send the form back to you for completion).

Before you continue with the adoption application please take note of the following:

To be considered as an adopter, you must:

 Be 21 years of age or older (provide proof of identification)  Have identification showing your present address  Have the consent of your landlord in writing (if applicable)  Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care of the dog  We only home our dogs to homes where their existing pets are sterilised  For the safety of our dogs we do require them to sleep inside at night and be a part of the family. If the dog is outside during the day shelter in the shade will be required  Under no circumstances do we allow any of the adopted dogs to be chained

Page | 1 ADOPTION APPLICATION FORM

PERSONAL DETAILS

1. Name and Surname

2. ID number

3. Physical address

4. Contact details E mail address Home Work Cell 5. Married / divorced / living with someone / single

6. Employer & Occupation

7. Type of working hours (what time do you normally leave your home in the morning and at what time do you return). Do you work on weekends?

8. Hobbies

9. What relationship do you have / have you had with past dogs, and what kind of relationship do you want from the new dog?

10. Have you ever lost a dog / cat due to distemper, parvovirus, cat flue, sniffles, biliary or rabies. If so, please specify cause and time

11. How many dogs or cats have you owned over the past 3 years?

12. Which animals do you still have and what happened to the others?

13. Who will be the principle caregiver for your dog?

14. Number of members in household including domestic and garner Adults

Children (age)

15. Do children visit your home and if yes, what ages

PROPERTY DETAILS

16. Do you own, rent or stay on someone else’s property Rent Own Someone else’s (duration) property (specify) 17. If you are renting / staying on someone else’s property, do you have permission to have pets on the property?

If you are living in a townhouse complex or sectional title, we require written proof from the Body Corporate that you are allowed to keep dog/s and size they stipulate at your residence prior to the adoption. 18. If residing in a complex, please state type, number and size of dog permitted

19. Garden size and details (paved, lawn / combination)

20. House setting Urban Rural

21. Is your yard / garden fenced / walled and brief description (type and height)?

22. Is there a pool? Yes No

Is the pool fenced? Does the pool have a cover?

23. Please list how many homes you have lived in over the past 10 years and how long you lived in each home

24. Is there someone home during the day? If yes, who?

OTHER IMPORTANT INFORMATION

25. For what purposes do you want to adopt a Pointer? Companionship Guard dog Working dog (specify) Obedience trials/training Search & Rescue Family pet a. Have you ever turned No Yes (Please explain) your dog in to a Shelter? b. Have you ever had a pet No Yes (Please explain) euthanized?

c. Will your current pets No Yes accept and adjust easily to a new dog in the house? Please explain. d. Does any member of No Yes

your household have an allergy to dogs? e. How many hours each day will the dog be without human companionship? Please explain. f. Are you aware of dogs being/stolen poisoned in your area? Even if there are no incidents how will you prevent your dogs from being poisoned?/stolen g. Are there areas in the No Yes house that are off limits for your pets? If yes, please explain. h. Are there times when the No Yes dog(s) will be tethered (tied up)? If YES, please explain why & for how long. i. How much do you think it will cost per month to feed the dog j. What type and brand of food do you feed your dog? k. Do you leave the food out all day or do you take the food bowls away after ± 20 minutes?

l. A shelter dog Call the dog when When you find a you come across a soiled area you

soiled area, point ignore it the area out to the might not be dog and house trained. scold/punish him How will you When you catch Take the dog the dog in the act outside regularly to teach the dog to you distract/tell encourage him to use the outside him off and take urinate and/or facilities? him outside where defecate outside. Please tick the you praise him relevant box(es) enthusiastically if he urinates/defecates there m. How often will you take the dog for a walk and for how long or how far? n. Will you take the dog to a park? How often? o. Do you have pet medical aid / if so which one and will the rescue pet be added to the medical p. Where will the dog spend most of his/ her time during the day? q. Where will the dog sleep at night? r. Do you have shelter for your animals from the sun / rain

during the day? s. If you drive a bakkie / LDV and the back does not have a cover, would you allow the dog to ride in the back? t. If you go away for a few days, or on a vacation, who will take care of the dog? u. If you move, will you take the dog with you? v. Have you ever applied to GSP Rescue SA or another shelter in the past to adopt an animal? If YES, when? w. Have you ever handed animals to any shelter / rescue? If YES, please explain:

x. Are you willing to take responsibility for this dog for the next 10 to 15 years? If

NOT, please explain. y. What provisions will you make for the dog should you become unable to care for him/her?

26. Do you intent to keep the dog Inside Only/Inside Most Of The Time Outside And Garage Only Outside During The Day, Inside Nights/When Home Uses Dog Door – Access To Garage Only Uses Dog Door – Access To Inside The House 27. What are the sleeping arrangements for the dog? Inside the house Kennel Garage or stoep (specify) Other 28. Do you have an existing vet? Yes No

Vet’s name and number

29. Will you be willing to have a rescue representative visit your home / do a property check where you and your dogs will be staying? Yes No (please give reason)

30. Your dog experience First Time Dog Owner Yes No Have Had Many Dogs Yes No Have Had One Or Two Dogs Yes No Have You Ever Volunteered At A Shelter Yes No Have Attended Dog Training Classes Yes No If Yes, Name Of School/Trainer

31. Other pets Do you own any other pets? Yes No Are any of your current pets rescue pets Yes No Have you ever owned a rescue pet Yes No Please list what kind of pets you currently have, their ages, sex and if they are sterilised or not

32. Do you breed any of your pets? Yes No If yes, are you a registered breeder and where?

33. ARE YOU PLANNING TO MOVE IN THE NEAR FUTURE? Yes No 34. Is there anything else you would like us to know about the type of dog you are looking for?

DESIRED DOG PREFERENCES

35. Preferred dog sex Male Female

36. Age 2-4 months (like a 4-12 months(like 1-3 years 3+ years toddler) a teenager) (young adult) (sensible adult)

Senior or special needs (please specify) No Preference

37. Name(s) of dog(s) you are interested in (please list in order of which one you are most interested in, followed by other options

38. What behavior(s) do you desire or could you accept?

Very active (Take the dog with you for a jog every morning) Not very active (a couch potato) Calm/Gentle/Well-mannered/accepts strange dogs and people happily Reserved/Shy Excitable/High Energy Confident Playful Pushy/Tests the boundaries Protective of family/home Clingy/Dependent A dog that loves cuddles An independent dog Other

REFERENCES

39. Boarding Kennel or Groomer or Trainer or Vet (if applicable) Name Telephone no Address E-mail 40. A family member or person living with you Name Telephone no Address E-mail 41. References of friends or family members NOT living with you Name Telephone no Address E-mail Name Telephone no Address E-mail

BREED EXPERIENCE

42. Have you ever owned a Pointer before? If yes, please provide more information. If no, why are you interested in adopting one now?

43. Are you aware and accept that Pointers NEED a lot of exercise, have a strong instinct to hunt small prey, shed hair and long for interaction with their humans? Yes No

44. Are you aware of that Pointers are medium to large breed dogs and although they have short hair, they do shed hair that could stick to clothes and furniture? Yes No

45. If you have never owned a Pointer have you read up on the breed and are you aware that Pointers like any other breed are often “runners” that need to be KEPT SAFE and away from where they can “escape”? Yes No

VERY IMPORTANT APPLICANT ACKNOWLEDGEMENTS / TERMS AND CONDITIONS

PLEASE READ CAREFULLY AND INITIAL AFTER EACH NUMBERED PARAGRAPH

In the event of this application being approved, inclusive of home check, meet and greet, and the Applicant paying the veterinarian directly for all expenses relating to the adopted animal (whichever is outstanding i.e. microchipping, deworming, vaccination and/or sterilization), the abovementioned Applicant agrees to adopt an animal from GSP Rescue SA subject to irrevocably agreeing and undertaking to comply with the following Terms & Conditions:

1. Should the adopted animal fall ill within 7 (seven) days of adoption with a deadly infectious disease (parvovirus/ distemper etc.), the Applicant will notify GSP Rescue SA immediately.

2. If the adoption application form and home check is approved, the Applicant shall drive to where the adopted animal is currently kept for a “meet and greet”. Occasionally, the dog is brought to the Applicant, however these are rare exceptions when the present foster or owner of the dog is willing and able and they specifically wish to also see the premises where it is proposed that the dog will live.

3. “Meet and greets”, if in the same region, occur on NEUTRAL turf if introducing any existing dogs from the Applicant’s home. Please understand that many dogs are leash-aggressive and owner- protective when on a leash. The true nature of how these dogs will engage is if they are all introduced to one another one at a time (i.e. not all in the large enclosed “play space” at the same time).

4. The Applicant undertakes to notify GSP Rescue SA in the event that the adopted animal dies at any stage for whatsoever reason.

5. The Applicant will notify GSP Rescue SA immediately of any behavioral issues in bullet point format. This is to ensure that GSP Rescue SA can actively obtain input from positive reinforcement behaviorists which the Applicant is welcome to make use of, at the Applicant’s expense.

6. The Applicant understands that GSP Rescue SA cannot be held liable for any medical expenditure occurring after the animal/s has/have been adopted. The Applicant is responsible for any medical expenses pertaining to the dog from the Confirmation of Adoption Date.

7. The Applicant undertakes to care for, love unconditionally and make their new adopted animal part of their family. The Applicant promises to ensure that the adopted animal/s is/are comfortable with suitable damp and draught-proof shelter of a reasonable size and to make sure that fresh food and water is provided at all times.

8. The Applicant undertakes to keep the adopted animal properly enclosed for a timeframe as long as may be required for the new companion to become accustomed with its new surroundings - the timeframe of such enclosure may vary from a couple of days to a couple of weeks depending on each animal.

9. The Applicant undertakes to ensure this animal receives the 5 basic needs namely, Food and Water, Shelter, Healthcare, Socialisation & Love.

10. The Applicant is to fit the adopted animal with a comfortable fitting collar (not tight) and name tag with full contact details on name tag which will be amended if contact details change. Similarly, the adopted animal must be microchipped and the microchip details are to be amended if physical address or cellphone number changes.

11. The Applicant understands that the animal MAY NOT be chained or fastened under any circumstances and must be allowed full access to the available property yard.

12. The Applicant undertakes to fully and yearly vaccinate the adopted animal. In addition, the Applicant will de-worm this animal every 6 months, do preventative treatment for other parasites (fleas, ticks and spirocerca lupi) and take it for its yearly vaccinations, the costs of which will be for my own account. Monthly Milbemax® treatment is an approved preventative treatment for spirocerca lupi and a de-wormer and monthly Frontline or 8 month Bayer Seresto Flea and Tick Collar are highly recommended for ticks).

13. Veterinary care for the adopted animal related to any medical condition, including emergencies and age-related conditions will be provided by a private veterinarian and NOT from welfare organisations. It is a specific condition of adopting from GSP Rescue SA that a private veterinarian can be afforded.

14. The Applicant undertakes to ensure that the adopted animal is kept safely at the back of the property and/or inside house when the Applicant / caretaker is not home. Too many dogs are poisoned or stolen because they are left at the front yard.

15. If for any reason the Applicant decides that he/she no longer wants the animal/s - the animal/s will be returned to GSP Rescue SA and GSP Rescue SA will be the first to be informed (no advertising of the dog on websites or Facebook pages nor on emails – these often place dogs in grave danger). The animal/s will not be placed in a new home without the permission of GSP Rescue SA. A new contract will be signed with the new proposed home and GSP Rescue SA, following the same rigorous process that the Applicant went through with GSP Rescue SA, and strictly subject to a home check. Should the Applicant surrender the adopted animal (which must ONLY be to GSP Rescue SA), that Applicant and/or friends and/or family of such Applicant will not automatically qualify to lay claim to such animal a matter of hours, days, weeks, months or years later. In such an instance, a new adoption application will be initiated in accordance with GSP Rescue SA’s procedures.

16. Please allow the adopted animal reasonable time to adjust to his or her new home.

17. The adopted animal may under no circumstances be subjected to tail docking, ear clipping, declawing or removal / cutting of vocal cords.

18. The Applicant undertakes to keep the adopted animal clean, safe and healthy to the best of their ability and to ensure that all necessary vaccinations are up to date. Note that the forever home is responsible for all veterinary bills pertaining to the adopted animal with effect from the Confirmation of Adoption Date i.e. when written notice is given that the dog is announced as homed to the Applicant.

19. Applicant will advise GSP Rescue SA IMMEDIATELY if the animal has gone missing, been stolen, or has died.

20. GSP Rescue SA reserves the right to do further home visits at its sole discretion should it determine that it is in the best interest of the animal to do so or if GSP Rescue SA includes you in our periodic home visits where we stay in touch with forever homes by telephone, on email, and/or with repeat home visits. GSP Rescue SA has the right to confiscate the adopted animal at any time at its sole discretion should it determine that it is in the best interests of the adopted animal to do so.

21. Should the animal be rehomed or surrendered without notifying GSP Rescue SA (which at all times reserves the right to be the only ones to rehome the dog), the adopter will be placed on our “not suitable for adoption” file and GSP Rescue SA will notify their affiliated rescue organisations and be entitled to post a notification on the Facebook page https://www.facebook.com/groups/553232744796519/

22. It is very important to GSP Rescue SA to ensure that every animal rehomed by ourselves is happy and healthy. Accordingly, GSP Rescue SA would like periodic photograph updates on any animal the organisation rehomes (at least one photographic update in the first week following adoption, then once a month during the first three months following adoption, and thereafter once every 6 months for the duration of the animal’s lifetime).

23. GSP Rescue SA will not be held liable for any injury or damage caused by the adopted animal, whether to humans or other animals/pets/domestic workers/gardeners/children or any person or animal following the adoption date.

24. Each page of this adoption application form has been initialed by the Applicant and the final page signed.

I hereby state that all of the questions above were answered truthfully and fully to the best of my knowledge.

I understand that my adoption application is approved subject to a home check by a representative of GSP Rescue SA and it is solely at their discretion to refuse my application, in which case a home check will not occur. An application can be refused once the home check or the meet ‘n greet have taken place. Only once the dog is up to date on vaccinations; microchipping; deworming (once every 3 months); and sterilisation (which I have

Page | 13 ADOPTION APPLICATION FORM paid for direct to the veterinarian ahead of this taking place, whatever the dog still requires), and I have been approved on the adoption application form as well as the home check, can the dog be considered as mine.

Signed at ______(suburb) on this ______Day of ______(Year).

Signature

______

SIGNATURE OF APPLICANT

Thank you for your interest in adopting one of our dogs at GSP Rescue SA NPC 2016/168762/08

While we will do everything possible to complete the adoption process as quickly as possible, the process can take a week or more.

Thank you for your patience.

FOR OFFICE USE ONLY

Dog adopted on date

Sterilised

Microchipped Number :

Vaccinated 5-in-1

De-wormed

Rabies

Kennel Cough

By which vet?

If a puppy, when is sterilisation date due : DATE FOR STERILISATION:

Dog was from (specify and owners details)

Emigration case

Down-sizing

Hand-over

Unwanted

Other shelter

Property Checker Name:

Date check was done

FOR OFFICE USE ONLY: DATE

APPROVED

DECLINED

COMMENTS

APPROVED BY

SIGNATURE

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