Dog Applying For:
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Adoption Type
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If the dog you are applying for is not the right match, would you be interested in being paired with a different dog?
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Would you accept a dog with special needs such as
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Your Name
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Your Age
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Your Email
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Your Occupation
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Your Annual income
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Your Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Your Phone
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(###)
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Co-Applicant (if any)
Co-applicant's Age
Is the co-applicant living at the same address as you?
How many people are in the household?
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Number of adults in the house
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Age of adults
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Do you have any kids? If yes, how old?
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Is anyone in your house allergic to dogs?
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Who will be responsible for daily care and training of your new dog(s)?
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Type of Residence
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Do you own or rent your home?
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If you rent, provide your landlord/owners name
Landlord/Owners phone number
(###)
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Landlord/Owners Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Is there a pet deposit?
If yes, how much?
Does your municipality or HOA have breed specific restrictions?
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Do you have a fenced yard?
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How tall is the fence?
What is your fence made of?
Fully fenced?
Partially fenced
Do you have a pool?
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How long have you lived at this address?
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How often have you moved within the past 5 years?
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Emergency Contact Name and Number
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Reference #1 Phone Number
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Reference #1 Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Relationship to the Reference #1
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Reference #2 Phone Number
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(###)
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Reference #2 Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Relationship to Reference #2
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Are you a first time dog owner?
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Do you have experience with the breed you are applying for?
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If no, have you done research about the breed you are applying for?
Name of Veterinarian used for current or previous pets within the past 5 years
Veterinarian Phone Number
(###)
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Do you give permission for WWDR to contact your Veterinarian?
Under which owner’s name and phone number are the current or previous pets registered at the veterinarian?
Would you allow a representative of WWDR to do a home visit?
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What kind of personality are you looking for in a dog?
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Please list any previous pets owned within the past 10 years
Were your pets spayed/neutered?
What flea/tick prevention are you using?
What heartworm prevention are you using?
What brand of dog food are you using?
Are your current dogs up to date on their vaccinations?
Are your current pets microchipped and registered?
What is your reason to adopt this pet?
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Did you ever have to rehome a pet or surrender one to a shelter?
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If YES why did you surrender the pet?
If your pet develops a serious medical condition what would you do?
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Which behavior would keep you from adopting?
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How would you discipline your dog?
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Do all members of the family know that you are planning to adopt a pet?
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Is the pet supposed to be a gift?
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If so for whom?
Does anyone in your household have serious health problems?
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If yes, please explain:
Please list the name and number of the person who will care for your pets if you become ill or can no longer care for your pets:
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Under which circumstances would you consider to rehome your dog?
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Would you consider adopting a dog who is not housebroken yet?
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If yes, What training method would you use to potty train?
Have you ever had serious behavior issues with a pet?
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If Yes, please explain:
Would you live with, date, or marry someone who does not like pets?
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Where will the dog primarily spend its days?
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Do any of your current pets live primarily outdoors?
Do you have a doggy door?
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Do you use a runner/trolly/chain?
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How many hours would the pet be alone on a daily basis?
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Where would the dog be when you are at home?
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Where would the dog be if you are NOT at home?
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If other, please explain
Where would the dog sleep at night?
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How often would you take your dog for a walk?
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Do you smoke tobacco products? If so where do you smoke?
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Any other information you want to tell us about yourself:
I certify that the above information is accurate, and that I have willingly given Wags and Wiggles Dog Rescue the correct information. I will notify Wags and Wiggles Dog Rescue of any changes related to this information. Signature of Applicant/ Date Signed:
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Contractual Agreement
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ATTENTION:
Completion of this agreement does NOT guarantee that you will be approved for the adoption with Wags and Wiggles Dog Rescue. We are dedicated to placing our dogs in the best homes possible. Therefore, we may decide to take more than one pre-approved adopter on any of our animals and will contact references that you have provided to ensure that we make the best decision for both the potential adopting individual/family and pet. We appreciate your patience while we make our decision. After all, this decision will be one that will last for the lifetime of your pet!
CONTRACT AND RELEASE
1) The animal will receive proper food and water, shelter, and loving humane treatment by myself and other family members, and will not be left alone for extended periods of time (more than an average work day).
2) THE PET HAS TO BE KEPT UP TO DATE ON VACCINES AND HEARTWORM PREVENTION AT ALL TIMES!
3) The animal is to be kept indoors and not allowed to run unsupervised in an outdoor environment or tied up or chained at any time.
4) I understand that Wags and Wiggles Dog Rescue has little knowledge of the animal, including its medical condition/background and disposition of the animal. Joan Locher, Wendy McMahon and Lally Peebles - Wags and Wiggles Dog Rescue - make no warranties with regard to the health of the animal and disclaims any liability for the animal’s medical condition, sickness or disease.
5) The animal will not be subject to harassment by myself or other persons who live or visit my home and will be protected from other animals in my care. Additionally, the animal will not be used for purposes of experimentation or for breeding. By any violation of this contract WWDR is allowed to claim the animal and the animal has to be returned into the custody of a representative of WWDR.
6) I understand that a WWDR representative may inspect my home and the animal, upon their request and I’m not allowed to re home the animal to a third party without the approval of Wags and Wiggles Dog Rescue. The new pet owner is not supposed to re-home the adopted pet to a third party without consulting with WWDR representative and get the agreement that the third party meets all requirements. A new adoption contract has to be signed but the re-homing fee will be waived.
7) A WWDR representative has the right to get frequently updated information on the pet’s health and do house visits and has the right to take custody of the pet if a stable home environment and medical care isn’t deemed appropriate.
8) I release Wags and Wiggles Dog Rescue, its Board of Directors, volunteers, foster homes and representatives, and the veterinarian treating the animal at the request of WWDR, from any and all claims and actions, whether for property damage caused by the animal(s) or trial to adopt, or adopted. Wags and Wiggles Dog Rescue is released from any personal injury to me, family members and/or friends and other animals in my care (personal pets or livestock) from biting, scratching, transmission of disease, and/or any other matter attributable to said animal(s).
9) Our rescue will take in the pet again at any time in case the adopters situation changes or the pet turns out not to be the right fit.
10) I understand that in the case I can’t care for the pet any longer and have a third party interested, it has to be brought to the attention of WAGS AND WIGGLES DOG RESCUE. The third party has to be approved by WWDR. Otherwise the animal has to be returned to the rescue.
11) The pet is micro chipped in the rescue Wags and Wiggles Dog Rescue name and is not allowed to be removed from the registration at any time. The new owner can be added to the microchip after adoption.
12) With this contract the new pet owner agrees and understands that it is part of the adoption contract that the new dog will not have their ears cropped or tail docked unless it is for a medical reason. It is a violation of this contract and the pet will have to return to our rescue.
13) If the new pet owner moves away from the address which was given in the adoption contract it is required that we get updated living information.
14) Proper medical care if needed, vaccinations and preventative care for heartworm disease has to be provided at all times. Heartworm prevention has to be given monthly every year - with no breaks.
15) An adoption fee of $___ is due by adoption date (non refundable)
16) Within 30 days after adoption, the adopter must introduce the pet to a vet of his choosing and provide us proof of the purchase of a 6 month supply of heartworm preventative.
17) WWDR will delete the adopted pet from our insurance policy within 24 hours. We advise that you put your new pet on your own insurance policy.
18) WWDR does not allow invisible or electric fencing as a means to contain our dogs in the yard. Many other types of fencing are allowed which will be discussed with WWDR.
I UNDERSTAND AND AGREE TO THE ABOVE TERMS. IF, AT ANY TIME, I AM UNABLE TO CARE FOR THE ANIMAL ACCORDING TO THE CONDITIONS STATED ABOVE, I WILL ALLOW A WWDR REPRESENTATIVE TO RESUME OWNERSHIP OF THE ANIMAL OR FIND AN ALTERNATIVE SOLUTION.
I UNDERSTAND THAT IF I KNOWINGLY FAIL TO COMPLY WITH THE ABOVE TERMS, OR IN ANY WAY PUT THE ANIMAL IN A SITUATION WHICH ENDANGERS THEIR HEALTH, WAGS AND WIGGLES DOG RESCUE MAY TAKE APPROPRIATE ACTION, INCLUDING TAKING THE PET FROM MY POSSESSION AND/OR TAKE LEGAL ACTION AGAINST ME.
