Apply for a BRAVEHOUND↵

If you are human, leave this field blank.

BRAVEHOUND Companion Questionnaire

Title

First Name

Last Name

Address

Email

Home Telephone

Mobile

Date of Birth dd/mm/yy

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

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

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

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

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

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

Submit

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.