Please enable JavaScript in your browser to complete this form.Contact Information:Dog NameApplicant Full Name: *Date of Birth *Email *Mobile *LandlineCountry *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCity *Region *Street *Building *Floor *StateZip CodeOccupation *If out of reach, whom can we contact?Name *Mobile *Personal Information:Type of property ownership: *LeaseholdFreeholdIf you are a leaseholder, does your landlord allow dogs? *YesNoHow many members are living in your household? *Is everyone in your household in agreement about adopting a dog? *YesNoDoes anyone in your household have allergies to dogs? *YesNoWhat will you do if someone in your household develops allergies to this dog? *Why do you want to adopt this dog? *Child CompanionHouse PetOwn CompanionSecurityHave you ever adopted a pet before? *YesNoDo you currently have a dog or a cat or any other pets? *YesNoDog(s)Cat(s)OtherIs / are your pet(s) castrated? *YesNoIs / are your cat(s) declawed? *YesNoPlease list the name of the vet and his contact number or the clinic number: *How many hours in an average workday will your dog spend without human contact? *Are you capable of training the dog to show wanted behavior around the house or seek professional positive reinforcement trainers if need arises? *Does your house have a garden? *YesNoWill the pet be indoor or outdoor? *IndoorOutdoorPlease describe how do you spend your weekends? *Please describe how physically active your lifestyle is? *What energy level do you think would work for your lifestyle? *Low maintenance - No WalksMellow - Short Daily WalksActive - Short Walks & Dog Play-DatesEnergetic - Long Walks, Running, Hiking, etc.Would you be willing to adopt a different pet if we determine that the pet you are applying for is not right fit to your lifesyle? *YesNoPlease state the name and phone number of the person who might take care of the pet during your absence:Name: *Mobile *Do you plan on moving in the next 12 months? *YesNoIf yes, what do you plan to do with the pet? *Have you ever had to surrender an animal to a shelter? *YesNoIf yes, please explainOther Information:May we contact you regarding volunteer opportunities?YesNoMay we contact you in order to help with fundraising?YesNoWhat is your Facebook or Instagram account? *Adoption Policies & Procedures: After you have adopted a pet from Alyarz Pet Club and signed the contract, it is important to note the following guidelines. In the event of mistreatment, Alyarz Pet Club retains both possession and ownership of the pet and may take legal action. Such mistreatment would be considered a breach of the adoption contract. By adopting a pet, you agree not to abuse or neglect them. Additionally, the pet cannot be given as a gift to another person. You understand that, to the best of our knowledge, the pet is in good health at the time of adoption, and any medical expenses incurred after the adoption date are not the responsibility of Alyarz Pet Club. However, if a health issue arises within the first three days, please notify Alyarz Pet Club immediately to discuss the matter. Furthermore, as part of the adoption agreement, you agree to grant Alyarz Pet Club visitation rights to ensure that the terms of the Adoption Agreement are being upheld. These visitations serve to verify that the pet is being well-cared for and receiving the attention they deserve. *I agreeI understand that APC requires the above information to insure that the pet is placed in a good home. I certify that the above information is true and I understand that APC will reclaim the pet if they discover any part of the adoption contract is violated? *YesNoAdopt
