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Wags Adoption Application

Name of the Dog You Are Interested In A value is required.

Contact Information

Name A value is required.
Age A value is required.	Must Be 18 to Adopt
Street Address A value is required.
City A value is required.
State A value is required.
Zip A value is required.
Phone A value is required.
Work Phone A value is required.
Occupation A value is required.
Email A value is required.

Home Information

How many adults in the house A value is required.
How many children in the house A value is required	Children's ages A value is required.
Do You Own Or Rent Your Home? Own Rent Please make a selection.	What Sort of Home Do You Live In? Single Family Home Multi Family Home Mobile Home Apartment condominium Row Home Town Home Please make a selection.

Name of Landlord or HOA or self if you own A value is required.
Address of Landlord or HOA or self if you own A value is required.
Phone Number for Landlord or HOA or self if you own A value is required.
Do You Have a Fenced in Yard?     Yes     No Please make a selection.
What Size is the Fenced in portion? enter 0 if no fence A value is required.
Would you be willing to Fence in a portion of your yard
as a condition of the adoption ? Yes    No Please make a selection.
Are there any structures that would allow your dog to get over the fence? Yes     No Please make a selection.
Does any one in the home have any medical conditions or physical limitations
that might cause difficulty in living with or caring for a pet?     Yes     No
Please make a selection.
Could you Explain any medical conditions: If there are no medical conditions enter none
A value is required.
How Would you describe your Household Activity Level     Low     Medium     High Please make a selection.

General Adoption Questions

Why do you want a new dog
A value is required.
Please list all pets you currently have including pet's name and type
A value is required.
How many pets have you owned in the past and what type?
A value is required.
Have you ever trained dogs? :     Yes     No Please make a selection.
What Commands have you taught? if none enter none A value is required.
What methods of correcting mistakes were used? if none enter none A value is required.
Are you familiar with crate training?     Yes     No Please make a selection.
Are you willing to learn and use crate training as a condition of adoption ?    Yes     No Please make a selection.
How many hours a day will your dog be alone A value is required.
Where will your dog spend its days? A value is required.
Where will your dog sleep? A value is required.
How will your dog receive physical exercise? A value is required.
What books or other materials have you read concerning dog training or dog behavior A value is required.
Does everyone in the family want this dog and willing to spend time with it? Yes     No Please make a selection.
Who will be the primary caregiver of your dog? A value is required.
Approximately how many adult visitors do you have a month A value is required.
Approximately how many children visit your house in a month A value is required.

In addition to a regular life at home would your dog (check all that apply)
Walk routinely with a family member
Compete in obedience trails or other dog sports
Go to work with you
Travel with you
Be a playmate for you, your children, or pets

Which dog(s) are you interested in if the dog listed above is not available A value is required.
Do you have a gender preference as a condition of adoption? A value is required.
Do you have an age preference as a condition of adoption? If yes please list A value is required.
Occasionally a dog with special needs (physical restrictions or senior dog) is
available for adoption. Would you consider such a dog? Yes     No Please make a selection.
Are you financially prepared to provide regular veterinary care? Yes     No Please make a selection.
Considering all dogs you have owned, what health issues have you experienced and what kinds of routine veterinary care was given, generally speaking A value is required.
Do you currently have a veterinarian? Yes     No Please make a selection.
May we contact your vet? Yes     No Please make a selection.
Vet's Name A value is required.
Vet's Address A value is required.
Vet's Phone Number A value is required.
If you do not currently have a vet you must provide at least 2 non-family personal references. Include name, phone, and relationship.
Personal Reference 1 A value is required.
Personal Reference 2 A value is required.
Personal Reference 3 A value is required.
Personal Reference 4 A value is required.
When you go out of town, who will care for your dog? A value is required.
If you had to move for any reason, would you bring your dog with you? Yes     No Please make a selection.
How did you find Wags Rescue? A value is required.
Please add any additional information you feel will help us find the right dog for you. A value is required.

I understand that my adopted pet must be kept on Heartworm medication all year around and I agree to keep to this regime. Yes     No Please make a selection.
Terms

I understand the responsibilities that I am assuming by adopting a rescue dog.
I know that there may be unforeseen circumstances and expenses with the introduction
of a new pet in my household. All medical expenses related to this animal will be my responsibility from the time of adoption. Wags will not reimburse veterinary medical
expenses for this animal.
I understand that WAGS Rescue is a non-profit all volunteer rescue group.
I understand that the donation made when I adopt a dog is necessary to help offset
costs incurred to rescue and care for each dog.

I understand the the Adoption fee is a NON-REFUNDABLE donation given to Wags so 
that we may continue our mission of saving dogs.

If the time comes that I can no longer care for the dog I understand that I will 
receive NO REFUND and that I must return the dog to Wags.

I understand to return my dog to wags I must contact Colleen Simeti at (267) 238-7892,
and I must submit to a 30 day waiting period in which one of two things will transpire:      
     1) A wags representative will work with the family to resolve any issues with the 
        dog that may be the cause for the returning the pet
     2) If the issues can not be resolved Wags will accept your surrender of the pet

I understand that I am not authorized to release this dog to any other party, whether
 related to me or not, and I agree that in any circumstance, if I can no longer keep
 this dog in its lifetime, the dog will be returned to Wags Rescue and Referral.

There is a $25.00 application fee, which is non- refundable, 
that is required before we are able to process your application.

This Fee will be credited towards your Adoption fee at the time you Adopt 
Our adoption fees are as follows:

Dogs and Puppies that         Dogs and Puppies that 
    Age                are spayed/neutered         are not spayed/neutered
Under 1 year               $300.00                 $250.00 + $100 Spay/Neuter deposit* 
1yr. to 3 yrs.             $300.00                 $200.00 + $100 Spay/Neuter deposit*
3yrs. to 5 yrs.            $200.00                 $200.00 + $100 Spay/Neuter deposit*
Over 5 yrs                 $150.00                 $150.00 + $100 Spay/Neuter deposit*

* Your $100 Spay/Neuter deposit will be returned Once your dog has been spayed or neutered

In case of a returned check, Wags will require the fees paid plus a $30.00 NSF fee.

A value is required.
I understand and accept all responsibilities outlined above Yes No Please make a selection.
Drivers License Number A value is required.
Name on drivers license A value is required.
State Drivers License was Issued A value is required.

If you click submit and are not redirected to the Application Fee page, please review your answers. Any answers marked in red need to be updated