Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Contact number:
Is the address you have provided where the animals will live? If not can you please describe where they would be and how you will be tending to them?
How frequently will you be checking on the animals?
What species of animal are you wishing to adopt and how many?
When are you seeking to accept the animals?
Do you currently have any other animals living with you? If so please tell us about them, as well as your reason for having them i.e rescue/companion animal,
If you do not currently have 'farm' animals in your care, please describe your experience with them?
Please describe what housing arrangements you have for them?
Please advise your fencing, pasture and land size available to them?
Can you please tell us a bit about your vet, who are they? How far from you are they? Are they experienced in treating 'farm' animals?
Please provide contact details for two references that are not relatives of yours.
If you are looking to adopt an animal other than poultry, you are required to have a current PIC number. Note: this is a legal requirement for anyone housing goats, sheep, horses, deer, cattle, pigs, camels, alpacas or llamas on their property. There is no cost to apply for a PIC number. Please provide yours here.
Rescue, rehabilitation and on-going care is costly. We also would like to avoid enquires from those simply looking for 'free' animals. For these reasons we ask adopters to make a donation to help us continue our life-saving work. Please state the amount you are able to donate to Rose's Refuge.
Do you have an natural disaster emergency plan? If so, please describe it to us.