Adoption Checklist - Chance 4 Change
Name
*
First Name
Last Name
Phone number
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of prospective adoptive dog.
*
1. Proof of home ownership - e.g. Rates invoice.
*
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2. Photos providing a visual overview of the fenced section of your property.
*
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3. Do you currently own a dog? If no, please continue to question 7.
*
Yes.
No.
There is a dog on the property that I do not own.
Please answer the subsequent questions relating to your existing dog. 4. Verification of local council registration.
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5. Evidence of completed desexing procedure.
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6. Proof of multi-dog license or 3+ permit.
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7. Additional requirements.
*
Household adoption meeting (including existing dog(s).
Property inspection.
Adoption contract.
8. Desired date of trial commencement.
*
-
Day
-
Month
Year
Date
Payment
*
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( X )
1. Adoption Fee
$
500.00
NZD
2. Adoption Fee - Maltese X Shih Tzu
$
1,000.00
NZD
Payment Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Signature
*
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