If you are human, leave this field blank.PERSONAL DETAILSName *Address *CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityZip codePhone *Email * YOUR FAMILY & LIFESTYLENumber of Adults at Home *Number of Children at Home 0-7 years *Number of Children at Home 8-17 years *Does anyone have allergies? *NoYesIf yes - please explainHave you had dogs before? *NoYesHave you surrendered or given away a pet? *NoYesIf yes - please explainHow much exercise can you give your dog per day - Weekdays *How much exercise can you give your dog per day - Weekends *What would you enjoy doing with your dog? *Check all that applyOff-Leash WalkingOn-Leash WalkingJoggingWatching TVCyclingGamesYour employment / financial status *Full TimePart TimeStudentOtherFull Time - please tell us about your jobPart Time - please tell us about your jobStudent - please tell us about your studiesOther - please tell us about your daily commitmentsWhy do you want a dog? *Check all that applyHouse PetWatchdog / ProtectionAs a GiftChildren CompanionOther Pet CompanionFamily Companion YOUR HOMEWhat type of home do you live in? *HouseApartmentOtherDo you OwnDo you RentDo you have your landlord / property manager’s permission to have pets? *NoYesDo you have a fenced yard? *NoYesDog park attached to a complexOtherPlease explainWhat percentage of the time will the dog be left alone? *Where will the dog be left alone? *How much of the time will the dog be indoors? *How much of the time will the dog be outdoors? *Where will the dog sleep at night? *Do you have other pets? *NoYesIf yes, please list them *Please include Name - Type - Age - Sex - Spayed / Neutered TELL US WHAT YOU’RE LOOKING FOR Have you already fallen in love with a dog? *NoYesPlease tell us their nameSex *FemaleMaleNo PreferenceCoat *ShortMediumLongNon-SheddingNo PreferenceAge *PuppyAdultSeniorNo PreferenceSize *SmallMediumLargeNo PreferenceBreed / Type / Colour PreferenceI WOULD LIKE MY DOG TO * VERY IMPORTANT QUITE IMPORTANT NOT IMPORTANTBe friendly with children Be friendly with other dogs Be friendly with cats Be friendly with visitors to the house Enjoy being held Enjoy being petted Be calm Be playful Be quiet Be independent Never wake me up at night Never show aggressive behaviorSOME DOGS WILL REQUIRE TRAINING * YES NO NOT SUREI need a dog that is already trained I am a first time dog owner I have obedience trained before I have lots of experience and could handle a difficult dogPROBLEMS YOU ARE WILLING TO WORK ON *Check all that applySeparation AnxietyExcitabilityMild AggressionObedienceHouse TrainingFearfulnessReaction to Other DogsBarkingVocalizationI am not willing to work on these type of problemsUNDER WHAT CIRCUMSTANCES WOULD YOU SURRENDER YOUR DOG? *MovingToo CostlyNot Enough TimeBehavior ProblemsNeverOtherOther - please explain FALSIFIED INFORMATION WILL LEAD TO AUTOMATIC REJECTION OF THE APPLICATION. ELELPHANT NATURE PARK RESERVES THE RIGHT TO REFUSE ANY APPLICANT.I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adoption. The adoption of a lifelong animal friend should not be impulsive, but rather a carefully thought out decision, which will ensure a loving, lasting relationship.THANK YOU. THIS INFORMATION WILL HELP US MATCH YOU WITH THE RIGHT DOG FOR YOUR FAMILY.Captcha *reCAPTCHA is required.Submit
