Leicester Animal Aid Rescue and Rehoming Centre for Cats and Dogs

Call us on: 01455 888257

Interested Parties Form

The information on this form will be used to find a suitable dog for you. If you rehome a dog, we will retain a copy on file with the dog’s record.

If you have not found the right dog for you straight away, we will keep a copy on file and get in touch if we think we have the right match for you.

If you no longer wish to be contacted regarding finding a dog or cat, please contact the Centre on 01455 888257 or email info@leicesteranimalaid.org.uk to let us know.

Name of dog initial interest:

Title:

Full Name: *

Address Line 1: *

Address Line 2:

City:

Postcode: *

Home Tel. No:

Mobile(s):

Email: *

Date of Birth (dd/mm/yyyy): *

Age of Applicant: *

Alternatively, if you have not seen the dog for you on your first visit, what size, breed or age of dog are you looking for?

Size and Gender of Dog:*

Small (e.g. Terrier)

Medium (e.g. Collie)

Large (e.g. Labrador)

Male

Female

No Preference

Breed: *

Age of Dog:*

Puppy

Less than 2 years

2-5 years

5-8 years

8+ years

Any

Details of other pets:

No. of adults living at home:

No. of children living at home:

Visiting children?:

Age(s) of children living at home:

Age(s) of visiting children:

How long will the dog be left alone at home?:

How often will the dog be left alone and for what reason(s)?:

Have you owned a dog before?:

Is your home a?:

Is your home:

Do you have a garden?:

Approximate size?:

What type of fencing and how high?:

I would like my new dog to

Like children?:

Be good with cats?:

Like other dogs?:

Be good with livestock?:

Be housetrained?:

Be good when left alone?:

Like travelling in the car?:

Some of our dogs require training. Please tick any statement with which you agree:

I need a dog that has already been trained

I am a first time dog owner

I have trained pet dogs before

I would enjoy training a dog

I am an experienced owner and could train a difficult dog

Are you planning any of the following?:

A baby

Moving house

Holiday in next 2 months

Change in work hours

Please provide any further information that may help us to match a dog to your lifestyle:

Have you, or anyone in your immediate family, ever had any communication with the RSPCA regarding any pets?:

If yes, please provide details:

Have you ever had an application to rehome an animal declined by another Rescue organisation?:

If yes, please provide details:

Please read the following

LAA cannot make guarantees as to the health or behaviour of the dog.
Dogs cannot be used for commercial or guarding purposes.
LAA does not permit the use of residential training courses.
Dogs cannot be tied up or confined to outdoor living.
LAA does not permit the use of choke/check chains.
The owner is responsible for keeping the dog under proper control at all times.
The owner agrees to notify LAA of any change of address, telephone number or circumstances and will agree to retain the LAA ID tag on the dog’s collar at all times. In addition, the owner must provide their own ID tag containing the dog’s home address as required by law.
If an owner is unable to continue to care for their dog they must first notify LAA.

We like to keep in touch with supporters about news from Leicester Animal Aid, including fundraising activities and upcoming events. Would you like to receive news from Leicester Animal Aid by:

Post: *

Email: *

Telephone: *

SMS Text: *

Raffle

We currently send one set of raffle ticket books with our twice-yearly newsletter which you’ll receive if you’ve said ‘yes’ to receiving info by post. Each raffle book has 10 tickets in each and each ticket is 50p. 1st prize: £250, 2nd prize: £80, 3rd prize: £50. Please let us know how many you would like to receive.

Number of Raffle books: *

How did you hear about LAA?: *

Please confirm that you have read and understood our privacy policy:*

I have read and understood LAA's privacy policy

Signature (Your Name): *

Date: *

Leicester Animal Aid

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Interested Parties Form

Raffle

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