(SC042724)
All information supplied will be held in the strictest confidence and will not be shared with a third party.
Please read the application form carefully and answer ALL questions fully. Unfortunately failure to do this is
likely to result in a delay in processing your application.
We would like to direct you to the Home Page of this site where you will find lots of information about LRRSS which will be of use when filling out this form.
Name:
Telephone:
Mobile:
Email address:
Confirm email address:
Full Postal Address:
Postcode:
How long have you lived at this address?
If less than 5 years can you please also give your previous address (or addresses)?
Number of adults living at this address
Full name(s) and date(s) of birth of adults

Number of children
Full name(s) and age(s) of children
What is the main carer’s profession or occupation (or previous if retired)
What is their husband, wife or partner’s occupation?
Are there any adults or children in the household that have special needs? If so please give further information.
Are there any visiting children? If so what are their ages?
Have you ever owned a dog before? If so please give details of their breed and sex.
Do you have any existing dogs or other pets? If so, are the dogs neutered, and please give details of their breed, sex and age.
Please provide the name, address and telephone number of your previous/existing Vet Practice.
Do any of your neighbours have pets? If they have dogs, please name their breed.
Do you have any livestock nearby (e.g. sheep, cattle or horses)?
Does anyone in the household have allergies to dogs, cats or horses or asthma?
Have you adopted a dog before? Please give details.

Have you ever been refused a dog from any rescue?
Have you ever given a dog up for adoption? If so, please state why.
What type of accommodation do you live in? (Rented/owned flat/house) If you live in rented accommodation you will need to supply written permission from your landlord to keep a dog.
Do you have a secure, fenced and gated garden?
If you work, please tell us in detail how many hours in total that the dog would be left alone on any given day, i.e. if it would be for the morning, a lunchtime walk and then left again in the afternoon.
On any given day how long would the dog be left alone?
Would the dog live inside or outside the house?
Where would the dog sleep?
Would the dog have full or restricted access to the house?
Do you have any trips or holidays planned in the next few months? If so please indicate dates.
If you were away on holiday, who would look after the dog?

Have you considered the on-going cost of dog ownership, which would include vaccinations (yearly unless advised otherwise by LRRSS or Vet), worming, neutering, kennelling, food, chipping and general Vet bills?
Would you insure your dog?
Would your choice of dog food be dry, tins/wet?
How often would you feed the dog?
What training methods would you use?
Would you consider attending training classes if necessary?
Please indicate the age bracket you are interested in: e.g. the youngest to eldest age that you would consider, whether it is a female or male and if you have a preferred colour.
Would you consider adopting a pair of Labradors that have always been together?
Have you registered with any other Rescues? If yes, which one/s
Please tell us why you have decided to adopt a Labrador rather than to buy a puppy.

LRRSS Policies
It is the policy of LRRSS that all adopted dogs be neutered if required, unless advised otherwise by
LRRSS or a Vet. Written proof from your vet that this has been done must be sent to LRRSS to be kept on record.
Do you agree to this?
LRRSS requires that the new owner remain in contact with the Rescue for the duration of the dog’s life.
Do you agree to this?
The adopted Labrador cannot be rehomed by its new owner, that is, it is not transferable, but should the new owners’ circumstances change, such that they are unable to keep the dog, he or she will be returned to LRRSS.
Do you agree to this?
I/we agree to follow my/our Veterinary Surgeons advice regarding my adopted Labradors weight and weight control. (YES/NO)
There is a minimum adoption fee of £180 payable on day of adoption. Do you agree to this?
...............
I/We declare that the information given on this form is true and accurate and any misinformation given will preclude me/us from the application process.
Name Date
Completion of this pre adoption form is not a guarantee that a Labrador will be rehomed with you.
On receipt of your form, LRRSS will process your application and get back to you in due course.
After which, there will be a telephone interview and checks. References will be required.
Please submit your completed form to carolynepoultonlabs@gmail.com
If you would like any assistance with your application, please feel free to email Carolyne at the above address.
Thank you for your enquiry, we look forward to receiving your application.