Rescue Rehome Adoption Application

First Name *

Surname *

Street Number and Name *

Suburb/Town *

State *

Select an option ACT NSW NT QLD SA TAS VIC WA

Postcode *

Email *

Phone *

Alternative Phone Number *

Type of Residence *

Select an option Flat/Unit Standard Suburban Block Acreage (in Suburbia) Rural Property

Do you own or rent your home? *

Own your own home

Renting

Have you previously owned a Murray River Retriever? If yes, please supply detail *

Would you prefer *

Select an option Puppy Young Dog Older Dog

Would you prefer *

Male

Female

Either

Do you have children living in the house the puppy/dog is going to live in? *

Yes

No

If so, how many and their ages

Are there any other animals at the same property? *

Yes

No

If yes, which animals and how many?

Please add any further information you think may be helpful

Submit application