Apply for a BRAVEHOUND↵

BRAVEHOUND Companion Questionnaire

Name | Address | Contact Details

• Title
• First Name *
• Last Name *
• Address *
• Email *
• Home Telephone
• Mobile
• Date of Birth dd/mm/yy

Your Military Service Details

• Branch of Service (e.g. Army, RN, RAF, MN)
• Service No.
• Regiment, Ship etc.
• Date of Joining
• Date of Discharge
• Details of where you served and rank
• Decorations

Your Household

• How many people live in the household
• Number of Adults
• Number of Children
• Children's Ages
• Do you have regular visitors to the household
• Number of Adults
• Number of Children
• Please describe below how often they visit and the ages of the children
• What type of accommodation do you live in HouseFlatBungalowOther
• Do you OwnRentOther
• Do you have a garden YesNoShared
• Is it fully enclosed YesNo
• Please describe below the height and type of fence

Are you planning on any of the following

• A Baby YesNo
• Moving House YesNo
• Change of working hours YesNo
• Holiday in the next three months YesNo
• Present Working Hours/Commitments. Are you currently Full-time workerPart-time workerServing Service PersonnelRetired Service PersonnelFurther education:Currently unemployedOther
• Do You ShiftworkNight shiftWork away from homeWork from homeOther
• Have you or anyone in your immediate family ever been convicted of abusing or being cruel to an animal YesNo
• How many hours on average would your dog be left alone daily
• Have you considered taking your dog to work with you YesNoNot Possible
• Do you own another dog/dogs YesNo

If yes please fill in the details below

• Breed
• Gender
• Age
• Last Vaccinated
• Neutered YesNo
• Do you own any other pets. Please detail below
• Have you owned a dog before As a ChildAs an AdultNever
• Please provide details
• Are you applying for a Bravehound or Training Support for your own dog? BravehoundTraining Support
• Would your new dog come into contact with other dogs on a regular basis YesNo
• If yes please specify

Please use this box to note down any other information that you feel might relate to your application

• e.g. how much exercise, training and socialisation you could provide etc….

TERMS AND CONDITIONS – PLEASE READ AND TICK BUTTON TO AGREE

• You are over the age of 18
  .
• If you live in rented accommodation, you will undertake to provide proof of the allowance of dogs in your property before any dog can be reserved for adoption.
  .
• I agree to Bravehound discussing my suitability with PRU and /or other health professionals
  .
• Additional information upload here
• How did you hear about the Bravehound programme
• Date : dd/mm/yy

Thank You for your time

 

Verification

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Some of the applications have been submitted to us without a telephone number or email address.
We apologise that we are unable to respond to these as there is no way to contact you.
The submission form now makes these fields obligatory. We apologise for any inconvenience and ask you to re-submit your application. Thank you.