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Adopt a Dog Formgary2020-09-09T12:02:24+01:00

Online Adoption Form

Please read our Adoption Conditions and fill in the form below to register your interest.

Please read our adoption conditions for dogs

Adoption of Dogs

Whilst we are currently closed and unable to have visitors on site, we will be taking applications for our dogs. We are now doing pre-booked adoption appointments and we will contact you to arrange an appointment if suitable. Please do not be disheartened if we do not contact you about a specific dog as it is more than likely that we have had a high number of applications for that dog. We may contact you about others that come in and might be suitable. If we do get high numbers of applications, we will close applications and take the dog off the website. Please fill out the application form and email it to info@bleakholt.org There are a few situations that could cause us to decline the offer of a new home for one of our dogs and these are:

We do not rehome rescue animals to homes with children under five years old
We do not rehome young dogs to homes where they will be left alone for over four hours or five and a half hours for a dog who is four years old or more
We do not rehome rescue dogs to homes that do not have a secure garden or yard

I don't have a specific dog in mind

Animal Name

What made you choose this dog? (required)

What Sort of Dog do you Want?

Your Details

Your Name (required)

Date (required)

Your Email (required)

Your Address (required)

Postcode (required)

Contact Number

Your Mobile (required)

Your Environment

Does your home have a fully enclosed garden or yard?
YesNo

How high is the fencing or walls?

Will the dog come into contact with children?
YesNo

What ages are the children?

Do the children live with you are or just visit?

If visiting children how often will they visit?

Do you Work?
YesNo

How long will the dog be left alone for each day currently?

Do you Live in a House or Flat?
HouseFlat

If you live in a flat, which floor?

Is your home rented?
YesNo

If yes, can you provide proof you are allowed pets?

Animal Ownership

Have you owned a dog before?
YesNo

If yes, was the dog from Bleakholt?

If you have previously owned a dog before, how long ago?

What breeds have you owned?

What happened to your last dog?

Do you have any other animals?
YesNo

If so what are they?

Are your pet’s vaccinations up to date?

Are they neutered?

Are you fully aware of the costs of feeding and veterinary treatment for a dog?
YesNo

Does anyone in the household have any allergies?
YesNo

How many walks a day and for how long are you wanting to do?

Does the dog need to be sociable with other dogs?
YesNo

Please tick any of the following statements which apply
I am a first time dog ownerI have owned dogs beforeI am an experienced owner and could work with a dog with behavioural problems

Are you planning on any of the following in the near future:
A babyMoving houseHolidayChange of working hours

Bleakholt Animal Sanctuary will keep your data for as long as is reasonably necessary to fulfil the purpose for which it was collected. We never sell on any information but we have a legitimate interest in sharing your personal data with the following third parties: the relevant microchipping companies, Petplan and where needed the relevant vets. More information and our privacy policy can be found at www.bleakholt.org

I can confirm the information I have provided is correct to the best of my knowledge. I give my consent for Bleakholt to contact me with news and information about the sanctuary. I understand how my data will be used and consent to Bleakholt storing it for as long as is reasonably necessary.

I am over 18 years of age (required)

Signed (insert name to agree)

Earliest adoption date if successful:

© Bleakholt Animal Sanctuary
Bury Old Road, Edenfield Ramsbottom , Lancashire , BL0 0RX Telephone: 01706 822577
Bleakholt Animal Sanctuary is a Registered Charity No 1110503.
Company Registered in England and Wales No 5434781
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