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Irish Red and White Setter Club of GB
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IRWS Club GB
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Please complete this form and submit it to our Rescue Secretary
Name
Email
Phone
Address
Date
Are there any children in the home?
Yes
No
If yes, what age(s) are they children?
Do you own other dogs?
Yes
No
What age(s) are the dogs?
Are they neutered/spayed
Yes
No
Do you own cats?
Yes
No
Do you have other livestock
Yes
No
About them....
Is someone home all day?
Yes
No
If not, please explain arrangements for the dog's care while you're out ...
How long would the dog be left at any one time?
Do you have a safe, secure garden?
Yes
No
Do you have access to good, safe walks?
Yes
No
Are you on or near a busy road?
Yes
No
Please describe your garden including fencing:
Have you had an Irish Red and White Setter before?
Yes
No
What other breeds have you had and what happened to them
Are you, or have you ever been banned from keeping animals?
Yes
No
Do you own or rent your home?
Own
Rent
If you are renting, do you have the landlord's permission to take in a rescue dog?
Yes
no
Do you have a current vet?
Yes
No
Please let us have your vets contact details ...
Are you prepared to travel to collect a dog?
Yes
No
Which sex would you prefer
Dog
Bitch
Don't Mind
What age of dog would you consider?
<24 months
2-7 years
>7 years
Any
Are you prepared to deal with any problems that may be involved in rehoming a dog?
Yes
No
Would you mind telling us which age group you are?
<35
36-55 years
56-75 years
>75 years
Don't wish to say
If you have any health issues that could affect your ability to care for a dog, please tell us here ...
Please tell us why you would like to adopt an IRWS and what you feel you can offer the dog .....
Your details will be kept on our database for a period of 12 months, if, at any time before this you wish to have your name removed please contact us.
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