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Irish Red and White Setter Club of GB
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Application to Adopt an IRWS
Name
Address
Email
Contact Number
Are they any children in the home?
Yes
No
What are their ages?
Do you own any other dogs?
Yes
No
Are they neutered/spayed
Yes
No
What sex are they?
Male
Female
What breeds are your dogs?
Do you have cats?
Yes
No
Do you have other pets/livestock
Is someone home all day?
Yes
No
If not, please explain your working hours and dog care arrangements
How long would the dog be left alone at any one time
Do you have a secure, enclosed garden
Yes
No
Height of fencing?
Are you on or near a busy road?
Yes
No
Do you have access to good, safe walks?
No
Yes
Have you had an Irish Red and White Setter before?
No
Yes
Have you ever been banned from keeping animals
Yes
No
What other breeds have you had and what happened to them?
Do you own or rent your home?
Rent
Own
If renting do you have the landlord's permission to take in a rescue dog?
No
Yes
Not Applicable
Do you have a current vet?
Yes
No
Vet's contact details
Are you prepared to travel to collect a dog?
Yes
No
What sex of dog would you prefer?
Dog
Bitch
No Preference
Are you prepared to deal with the many problems involved with taking on a rescue dog - nervousness, chewing, house training, lead and recall training?
No
Yes
What age dog would you consider
<24 month
3-7 years
> 7 years
any age
Would you mind telling us what age group you are in?
<35 years
36-55 years
56-74 years
>75 years
not prepared to say
Have you any health issues that could affect your ability to care for a dog properly at all times?
Yes
No
Please tell us why you would like to rescue an Irish Red and White Setter and what you feel you can offer the dog.
Thank you for taking the time to complete the form. We will contact you when a suitable dog becomes available. Please remove the check from the box if you do not want your details kept on our secure database.
Date
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