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Dear candidate-adopters,

In anticipation of an eventual adoption, I kindly request you to fill out the following questionnaire.  These data will allow us to comply with your wishes as much as possible and will finally be favourable for you as well as for the selected one.  Please complete this list as correctly as possible.  We thank you for your cooperation and for your candidature and particularly because you will give one of our protégés a chance for a better life.  They certainly deserve it!


Personal information


What is arranged as one stays away for a long time e.g. a day or a weekend where the dog can not come?

Data veterinarian

Situation data

Important: Belangrijk: the dog should under no circumstances be kept in a kennel!