WESTERN AUSTRALIAN SHEPHERD RESCUE
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Available dogs: WA, OR, ID, MT
Available Dogs: CO, UT, NM, WY
Adoption Application
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Adoption Application
Please make sure you answer all fields with a * next to them. If you do not you will not be able to submit the form.
*
Indicates required field
Name(Guardian)
*
Dog Interested In:
*
Home Phone
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Cell Phone Number
*
Work Phone Number
*
Email
*
Occupation/ Employer
*
Veterinarian reference
*
Vet Phone
*
Personal Reference (not a relative or person that lives in the same house)
*
Personal Reference Phone
*
Rent/ Own
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LandLord (If Applicable) and Phone
*
House Type
*
House
Apartment
Townhouse
Other
If other please specify
*
Fenced Yard
*
Yes
No
If yes provide type, size and height
*
Kennel Run
*
Yes
No
If yes provide size and when it is used
*
Number of children in household (full and part time), provide age and genders
*
Number of adults in household (full and part time) provide age and genders
*
Other pets, provide types, ages and genders
*
Spayed/Neutered?
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Primary caregiver of this dog
*
How will this dog be exercised?
*
Where will the dog stay at night?
*
Where will the dog stay during the day?
*
How many hours a day will your dog be alone?
*
Will you use a tie-out, cable, or chain to restrain your dog outside?
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Is there an adult home during the day?
*
Do you plan to take this dog to obedience training?
*
Do you own a pickup truck?
*
If so, where will the dog ride?
*
Who will care for your dog in case of emergency? Vacation?
*
Activities you participate in that will include your dog:
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Hiking
Hunting
Camping
Walking
Couch Potato
Running
Agility
Frisbee
Biking
Other
If other or multiple please specify:
*
Your level of experience as a dog owner:
*
Novice
Somewhat experienced
expert
Have you had previous experience with rescue dogs?
*
Yes-if so explain below
No
Rescue Experience
*
Do you intend to provide your dog with a loving home for the rest of his life?
*
What characteristics do you expect of this dog?
*
Under what circumstances would you consider surrendering your dog?
*
Gender Preference
*
Male
Female
No Preference
Preferred Temperament
*
Mellow
Moderate Energy
Playful
Active
Would you consider a special needs dog such as one that requires daily medication?
*
Yes
No
Maybe
When are you prepared to adopt:
*
Now
Later
Date (Specify Below)
Adoption Date:
*
Do you agree to home check
*
Yes
No
A rescue dog MAY have experienced an unfortunate history of one or more of the following: neglect, abuse, abandonment, loneliness, insecurity, distrust. A period of adjustment (days for some, weeks for some) should be expected in some instances. Often the new dog is so grateful and overwhelmed with your show of love, devotion and consistency that she/he relaxes immediately and opens her/his heart to you. In either case, a rescue dog is almost always grateful, loyal, very affectionate, eager to please and very companionable.
Western Australian Shepherd Rescue's adoption donation ranges from $350-$650 to help with the costs of spay/neuter, vaccinations, heartworm test, microchip ID, and other administrative and foster care costs we incur. Depending on location of the dog, a transport fee may be added to the adoption fee. The rescue donation is due at the time of placement. Submission of your application does not guarantee placement of a dog. Applicants must agree to a home visit if asked for one.
I understand that any misrepresentation of fact may result in the removal of the placed dog from my home.
I understand that Western Aussie Rescue is not responsible for the accuracy of information received about the temperament habits or physical condition of dogs available for adoption. Western Aussie Rescue is neither liable nor responsible for any damage, injury or accident resulting from the placement of this dog. I will accept the responsibilities for the health, housing, feeding, training and companionship of this dog.
Dog's name
*
Description
*
Guardian's Signature
*
Date
*
By entering your full name above along with the date it is assumed to be a valid signature as if it was handwritten.
AFTER HITTING "SUBMIT" YOU SHOULD SEE A PAGE CONFIRMING YOUR APPLICATIONS WAS SUBMITTED. YOUR APPLICATION IS
NOT
SUBMITTED UNLESS YOU SEE THE CONFIRMATION PAGE. IF YOU DO NOT SEE THE CONFIRMATION PAGE CHECK TO MAKE SURE ALL THE FIELD ENTRIES ARE COMPLETE AND HIT SUBMIT AGAIN.
Submit
Home
Adopt!
Available dogs: WA, OR, ID, MT
Available Dogs: CO, UT, NM, WY
Adoption Application
Donate Now!
Support Us!
Fostering
Stories/Info
Success Stories
Memorials
Choosing an Aussie
Why Rescue
Contact WASR