Please note: completion of this form indicates an expression of interest only and does not guarantee adoption. *mandatory fieldName*Phone*Email Have you had a pocket pet before?*YesNoWhat species?*Do you currently have any pets?*YesNoWhat animals and how many?*Are your current pet/s registered with your local council?*YesNoWhat type of housing to you have?*Flat/ApartmentUnitHouseFarmDo you live in a rental property?*YesNoHave you received landlord approval for a pet?*YesNoWhat are your normal working hours?*Will the pet be an indoor or outdoor pet?*IndoorOutdoorBothWhere will the pet sleep?*Where will the pet be kept when you are out?*Who else lives in the house or will have regular contact with the pet?* Children Other adults Elderly Disabled Impaired N/A What age/s?*Do you travel regularly for work or holidays?*YesNoWho will look after the pet while you are away?*Are you fully aware of all the responsibilities and financial requirements regarding ownership of a pet?*YesNoIs there anything that you are aware of that would mean you will not be able to care for the animal for the rest of its life? E.g. moving/working overseas in the future*YesNoWhat arrangements would you put in place should that occur?*How did you hear about this animal?*Lort Smith websitePetRescue websiteSocial mediaWord of mouthOtherHow?*Is there anything else you would like to tell us about you, your household or lifestyle?