Please copy and paste the completed application and email to wags_rescue@yahoo.com. |
Applicant: Co-Applicant: Address: City: State: Zip Code: Home Phone: Cell Phone : Work Phone: E-mail Address: Occupation: 1.Which dog(s) are you interested in? 2. How many pets do you currently have?: 3. Please list the four most recent pet(s) with names included in the number above: 4. What other pets do you have in your home? 5. How many pets have you owned in the past? 6. Have you ever trained dogs? 8. If yes, what commands were taught? 9. What methods of correcting mistakes were used? 10. Are you familiar with crate training? If No, are you willing to learn more about it and consider the use of a crate (portable cage) as a housebreaking and transitional aid? 11. What books or other materials have you read concerning dog training or dog behavior? 12. Why do you want a new pet? 13. Number of people in household: Adults: Children: Childrens' Ages: 14. How would you describe your household activity level? 15. Number of hours a day will your dog be alone?: 16. Where will your dog sleep?: 17. Where will your dog spend most time during the day? 18. How will your dog receive physical exercise? 19. It is important that everyone in the family will want this dog and spend time with it. Who will have the primary responsibility for the care and well being of your dog? 20. Estimate the number of times per month adults visit you home?: 21. Estimate the number of times per month children visit you home?: 22. In addition to a regular life at home, would your dog (check all that may apply): Walk routinely with a family member Compete in obedience trials or other dog sports Go to obedience classes. Go to work with you. Travel with you. Be a playmate for your children or pets. 23. Do you live in a: Single family home Mobile Home Condominium Apartment Row Home Town Home 24. Do you rent? Yes No If you rent or lease, you must have written permission from your landlord; we would like this document at the time of any home visit. Please complete landlord information: Landlord's Name Phone# Address City State Zip 25. Is your yard fenced? Yes No If "Yes", please describe the size of the area, the height and the type of fencing material: If "No", would you fence all or part of the area as a condition of adoption? Yes No 26. Are there any structures that would allow your dog to climb out of this area? Any poisonous plants? A pool? Electrical meter or unusual features? 27. Which dog/s are you interested in(if dog listed above is not available): 28. Which sex would you prefer as a condition of adoption? 29. What age would you prefer as a condition of adoption? 30. Occasionally, a dog with special needs (physical restrictions or senior dog, for example) is available for adoption. Would you consider such a dog? Yes No 31. Are you financially prepared to provide regular veterinary care? Yes No 32. Considering all dogs you have owned, what health issues have you experienced and what kinds of routine veterinary care was given, generally speaking: 33. Do you currently have a veterinarian? Yes No If "Yes", please complete your veterinarian's contact information: Vet's Name: Address: City: Phone Number: 34. May we contact your veterinarian? Yes No IF YOU DO NOT CURRENTLY HAVE A VET YOU MUST PROVIDE TWO PERSONAL REFERENCES. (NON-FAMILY MEMBERS) PLEASE LIST RELATIONSHIP OF REFERENCE. 35. Does anyone in the home have medical conditions ( such as allergies,asthma,etc) or physical limitations that might cause difficulty in living with or caring for a pet? Yes No If so, please explain: 36. When you go out of town, who will care for the dog? 37. If you had to move for any reason, would you bring your dog with you? Yes No If no, please explain 38. How did you find Wags Rescue? 39. Please add any additional information or thoughts you feel will help us find the right dog for you. I understand the responsibilities that I am assuming by adopting this animal. 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. By signing this application you will agree to the following: 1. Your new family member will see a vet within 5 days to ensure that all is in order with concern to health. 2. Your new family member will be spayed/neutered within 60 days of adoption unless prior authorization is granted to you by Wags Rescue. In order to receive your refund for spay and neuter you must send the certificate to P.O. Box 1514 Southampton, Pa 18966 3. You will provide humane care of the animal and comply with all ordinances in force in the area in which you reside. 4. You will contact Wags Rescue & Referral immediately if the animal is lost, stolen or dies. 5. You will not allow any person or entity to use your new family member for any experimental medical purposes whatsoever. 6. You will return your new family member to Wags Rescue and Referral if , at any time, you desire to relinquish custody of it. Under no circumstances shall your new family member be sold, given to another rescue, person or any other entity other than Wags Rescue and Referral or you may be subjected to and responsible for any and all legal costs involved with getting the animal back to Wags Rescue and Referral. 7. In case of your new family member not working out your pet MUST be returned to Wags Rescue, In the event that you choose not to do so you will be subjected to a $1000.00 fine and legal costs associated with getting the animal back . 8. You will not attempt to hold Wags Rescue and Referral, and/or its staff,volunteers or any other people involved with Wags Rescue and Referral responsible for any illness, damages,injuries which your new family member may do at any time in the future to any person or property. Including but not limited to yourself , your family, guests or invitees into your home. 9. You will not use your new family member for the purpose of hunting game. 10. You will provide all follow-up reports concerning your new family member if required by Wags Rescue and Referral when they are due. 11. You will ensure yearly physicals and vaccinations are provided to your new family and will report back to Wags Rescue and Referral if required at any time. 12. It is Wags policy that if more than the adoption fee is requested to be returned that the new family will need to be surrendered to Wags Rescue and Referral. 13. If you need to surrender you new family back to Wags, we will need 48 to 72 hours to find suitable, safe housing for the animal. We ask for a donation for the adoption: Dogs ( 6mos and older): $200.00 Puppies(5mos old or younger): $250.00 Spayed or Neutered Dog: $200.00 *** Please note that special adoption fees apply in such cases when a pet is micro-chipped or is breed specific********** There is a $25.00 application fee , which is non- refundable, that is required before we are able to consider any animal adopted. This fee will be deducted from your adoption fee. In case of a bounced check, Wags will require the fees paid plus a $30.00 NSF fee. Upon signing this agreement you agree to all items listed above and assume full responsibility both financially and medically for your new family member. Name(Printed):_________________________________________ Signature:______________________________________ Date: _________________________ DL#:____________________________ State: ________________________________________ |
| Wags Rescue and Referral PO Box 1514 Southampton, PA 18966 www.wagsrescue.com email: wags_rescue@yahoo.com |
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