Online Adoption Form

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

    I don't have a specific dog in mind

    Animal Name





    What Sort of Dog do you Want?


    Your Details








    Your Environment


    YesNo



    YesNo





    YesNo



    HouseFlat



    YesNo


    Animal Ownership


    YesNo






    YesNo





    YesNo


    YesNo



    YesNo


    I am a first time dog ownerI have owned dogs beforeI am an experienced owner and could work with a dog with behavioural problems


    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.