Adoption Application

Please complete the form below. We will be in touch shortly to discuss next steps!

First and Last Name (Nama Pemohon)*

Location / Address (Alamat)

Your email*

WhatsApp Number

Why do you want to adopt a dog? (Kenapa tertarik untuk mengadopsi anjing?)*

In what type of housing do you reside? (Apa jenis tempat tinggal pemohon?)*

Apartment (Kost)

House (Rumah)

Other (Lainnya)

Do you rent this property? (Apakah tempat tinggal ini sewa?)*

Yes (iya)

No (tidak)

Do you plan on moving in the next 12 months? (Apakah pemohon berencana pindah dalam satu tahun kedepan?)*

Yes (iya)

No (tidak)

If yes, what do you plan to do with the animal? (Jika iya, apa yang akan di lakukan terhadap anjing yang di adopsi?)

Why do you want to adopt a dog? (Kenapa tertarik untuk mengadopsi anjing?)*

Have you previously owned pets? (Apakah pernah memelihara binatang sebelumnya?)*

Which dog do you want to adopt? (anjing mana yang ingin Anda adopsi?)

Questions?

Shelter For Lombok Dogs
Lombok, Kuta & Mawun
ShelterForLombokDogs@gmail.com

Or donate directly via Mandiri Bank
Location: Praya
Account Number: 161-00-0798364-1
Account Name: Yayasan Peduli Hewan Lombok
SWIFT CODE: BMRIIDJA

With your help, we can transform the lives of Lombok's street dogs!

Your invaluable support, be it through volunteering or donating, empowers us to provide these vulnerable animals with the love, care, and safety they deserve.

Together, we can create a better tomorrow for these precious souls.

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Shelter for Lombok dogs is a non-profit organization registered in Indonesia, registration number: 5022021052101165