Please send to firstname.lastname@example.org your answers for the following form if you wish to adopt a dog.
Name of the dog(s) or cat(s) that you are interested in :
Your contact details
Family Name :
First Name :
Date of Birth :
Full Address :
Home Number :
Mobile Number :
Email Address :
What kind of home can you offer the dog
With a fenced garden
With an unfenced garden
Could you tell how long would the dog be staying alone at home
If you go on Holiday or if move to a different country what will you organise for your dog ?
How many children are in your home:
What ages ?
Have they ever lived with a pet ?
Dogs that you own
Knowledge about dogs
Have you already experienced adopting a dog or is it your first dog ?
Why did you chose to adopt a dog? Please feel free to add any other comment you have not yet had
the chance to share with us?
How did you hear about Chiens d'Ici et d'Ailleurs ?