Walton Salley Corgis and Friends of Walmarsh. Adoption Coordinator, Edith Stull

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1 Walton Salley Corgis and Friends of Walmarsh Adoption Coordinator, Edith Stull Edisto Island SC Thanks for your interest in a Rescue from Corgis and Friends of Walmarsh. I appreciate your interest in a rescue and our application process includes the following: 1. The application will be reviewed and vet references checked 2. Follow up phone call to you after steps one and two completed. We are volunteers with full time jobs, families, pets, foster dogs, and a million s a day. Being thorough in the completion of this application, and asking any questions you have when submitting it, tremendously helps us reply to you faster. Completion of Application below- you can complete and back to our Adoption Coordinator, Edith Stull (alove4dogs@outlook.com) or print and Fax to: The more information provided, the better we are able to help you in finding a rescue that would suit your needs and lifestyle. Please complete ALL questions in detail; the more information the better. First Name: Last Name: Co-Applicant Name: Street address: City: State: Zip: Home phone: Cell phone:

2 Work phone: address: Is there a specific dog you are applying for?: Which One? Name What are you looking for in a dog? Describe yourself your energy level, your interests, your favorite activities, etc. Describe your ideal dog its energy level, personality, level of training and special skills, etc. Size: age: sex: breed: current energy level desired: Would you consider a special needs dog or one who requires medication? Why do you feel this dog or type of dog is right for you? Have you researched the breed/breed mix you are interested in? Please elaborate! Please tell us a little about your lifestyle and what role your new dog will play? Number of adults (over 21) in household: Their relationship to adopter: (all adults must be present and involved with the adoption process) AGES OF ALL, starting with the primary adopter: Name Name relationship to you relationship to you Number of children in household:

3 AGES: Are there frequent visitors that should be noted (toddlers, elderly, anyone with special needs, etc. )? Does anyone listed have pet allergies? Do you live in an apartment, condo, duplex/townhouse, or mobile home? Does the PRIMARY ADOPTER Rent or own? How long have you lived there? Is your home in the city, suburbs or rural?: Are you willing to have a home check prior to approval of this application? Have you discussed getting a new dog with your landlord/condo association/home owner yet? Is there a restriction in the number, size and/or breed of animals that may live in a household? (this may be set my the town, landlord, condo association, neighborhood association, etc). ***For rentals, please include landlord s name and phone number, they will be contacted prior to approval. ***If a family member owns the property please proved their name and phone number. What pets do you currently own? 1. NAME: BREED: AGE: SEX: Spayed 2. NAME: BREED: AGE: SEX: Spayed 3. NAME: BREED: AGE: SEX: Spayed If more room is needed, you can add additional dogs here Do you purchase heartworm preventative for your current pet? What type do you use:

4 What other pets have you owned as an adult (over 21):? 1. NAME: BREED: AGE: SEX: Spayed Where is the pet now? *** 2. NAME: BREED: AGE: SEX: Spayed Where is the pet now? If sold, given away or surrendered to a shelter please explain the circumstances: 3. NAME: BREED: AGE: SEX: Spayed Where is the pet now? If sold, given away or surrendered to a shelter please explain the circumstances 4. NAME: BREED: AGE: SEX: Spayed Where is the pet now? If sold, given away or surrendered to a shelter please explain the circumstances Veterinary reference (if you have more then one or have switched recently please include all): YOUR VET SHOULD BE NOTIFIED THAT WE WILL BE CALLING. Clinic name and phone number: Name on file if not the primary applicant: If addition to your vet, please list 2 personal references we may contact: Name relationship to you /phone

5 Name /phone Relationship to you Why are you interested in adopting a dog in general? Why are you interested in this particular dog? Will the dog be kept inside or outdoors? On a typical day how long with the dog be left without humans? When left alone where will the dog be kept (all dogs are alone at one time or another, even if it is rare.)? ie; free in home, basement, garage, crate, outdoor kennel, tethered, other? Where will the dog sleep? Are you familiar with the use of a dog crate to train your dog when you are not home or at night? Would you like information? Do you plan to take your new dog to obedience training? Why or why not? Do you realize that it will take time for your new dog to adjust to its new home, especially if you have other pets? (usually 2-4 weeks and sometimes longer) They may require extra exercise or fewer visitors to your home at first. Are you willing to make adjustments to your daily routine during the adjustment period? Do you have a FULLY fenced yard? Please list height, material and size of fenced area: Would you or are you planning to fence? When & What kind? What BRAND of food will you feed your new dog? Would you like information on this? How MUCH exercise will your dog get? HOW do you plan to exercise him/her AND how OFTEN?

6 Who will care for your pets when you are a way for a period of time, such as traveling or hospitalized, etc? What would you do with your dog if you had to move? Do you have questions about the adoption process, or about having this animal or any other as a pet, that we can answer for you? Keep in mind that we are here to serve as a resource to help you and your new companion live a long a happy life together. If we don t have answers in regard to your questions or concerns, we will help you find the help you need. I/We attest that the information provided in the application is true and accurate to the best of I/our knowledge and any misrepresentation of fact will be cause for denial of adoption. I/We understand that submission of this application does not guarantee adoption of a dog. I/we understand that the rescue organization as done it s best to identify the correct breed or mix of breeds but do not guarantee accuracy. If completing thru word document, saving and returning by , please answer by checking the following BOX: YES Applicant s signature (only if faxing application) Date: Co-applicant:

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