APPLICATION TO ADOPT AND/OR FOSTER A WEST HIGHLAND WHITE TERRIER APPLICATION TO ADOPT A WEST HIGHLAND WHITE TERRIER Please read and carefully complete this application to adopt a Westie. We screen all applicants very carefully before placing a dog. Placement depends on the needs of the Westie and not on a first come first served basis for applicants. Please be as thorough and accurate as possible. Feel free to attach additional notes if you wish. All forms will be kept on file for one year. After that, any applicants still considering adopting a Westie should re-apply with their current information. Thank you for your cooperation. DATE Part I: Personal Information Surname: First Name: City: Province: Postal Code: Telephone: (Res) (Bus) Email Household members: Adults: Male Age (22-45 )(45-75 )(75+ ) Female Age (22-45 )(45-75 )(75+ ) Children: (M) (ages) (F)(ages) Residence: Acreage House Townhome Apartment Rented Owned Do the strata/tenancy rules allow you to have a pet? How many? Do you have a yard or dog run? Is it securely fenced? Height of the fence? Are there any known dangers in your yard, i.e. pool, deep garden pond, etc Are you prepared to make changes to your outdoor surroundings to accommodate a rescue dog?
Family: Has your family discussed the pros & cons of adopting a rescue dog? Yes No Are there any concerns? Are all members of your family in favor of adopting a Rescue dog? Yes No Will all members of the family be involved in the care of this dog? Do you plan to take this dog to Obedience class? How frequently are children under the age of 5 in your home? Are any members of your family allergic to pets? Do all members of your family work outside the home? Yes No How many hours will the dog be left alone during the day? Have you been considering any other breed of dog? Westies may live upwards of 15 years. Is your family prepared for this length of commitment? Yes No Older Westies may require special care? Would you be able to deal with this situation should you adopt an older dog? Yes No Is there anything you would like to tell us about your family s suitability to adopt a Westie? Pet History: Have you owned a dog or pet before? Yes No What Breed(s)? What became of your dog/pet? Do you currently have pets? Type and ages? Have you ever had a rescue animal before? Y N Please elaborate: Adopting a Westie: Why do you want a Westie? What age of dog are you looking for? Preference: Male Female Doesn t matter Would you be interested in an older dog? Do you plan on keeping this dog indoor or out? Where will he/she sleep? Where will the dog be kept while you are out? Will you use a dog crate? Do you expect a rescue dog to be house-broken? What kind of behavior do you expect from a rescue dog? How will you deal with behavior problems in a rescue dog?
How do you deal with a dog if discipline is required? Will you be able to separate the rescue dog from your other pets should a problem arise? Who will be the primary caregiver responsible for feeding, grooming and exercising your Westie? Knowing that veterinary care. Grooming, food and licensing can amount to about $500.00 per year and that your rescue Westie might live up to 15 or more years, are you prepared for the yearly and long term expenses for your Westie? will require a visit to your home. We will also wish to meet ALL members of your household. Do you anticipate any problems with this? Yes No Please explain:
REFERENCES References will be verified. Please list three references that can attest to your suitability as a pet owner, and more specifically, the owner of a rescued Westie. If you own, or previously owned any pets, you should include your Veterinarian as an additional reference. Furthermore, if you are renting, then you will also need to provide a reference from your landlord, along with a copy of your lease, or a statement from your landlord authorizing you to keep the dog Name: City; Province: Postal Code: Telephone (Res): Name: City; Province: Postal Code: Telephone (Res): Name: City; Province: Postal Code: Telephone (Res): Veterinarian: Landlord (if applicable):
I/We attest that, to the best of my/our knowledge, the above information is accurate and complete at the time of signing, and I/We understand that falsely provided information can mean that my/our application will be terminated. I/We understand and agree to make a donation to, and that the donation is not a fee or sale price, but a non-refundable donation once the adoption is final, which goes directly toward helping to offset all medical costs associated with 's services. Signature: Signature: Thank you for your cooperation. This comprehensive questionnaire helps us in placing the right dog with the right family. An improper placement, or one in which all the details weren t known, can end tragically, usually for the dog. Please return this application by email to at: info@westierescueofcanada.com or via snail mail at : c/o 227 Newdale Court North Vancouver, B.C. V7N 3H2
Part VIII: Verification of References & House Visit: (Please do not complete this section. It will be completed by a representative of ). Reference 1: Reference 2: Reference 3: Landlord: Veterinarian: House Visit by: Comments