Copy and Paste the Application
Copy and paste the application below, complete the fields and email it to westernaussierescue@gmail.com.
Western Aussie Rescue
APPLICATION FOR CANINE GUARDIANSHIP
return by email: westernaussierescue@gmail.com
1. Name (guardian)__________________________________
2. Dog interested in _________________________
3. Address____________________,______________,_____, zip___________
4. Home phone___________________, Work phone_________________,
Cell phone____________________, email________________________
5. Occupation/employer_________________________________________
6. Veterinarian reference _____________________phone______________
7. Personal reference_______________________phone________________
8. Rent/own? _______, Landlord___________________phone__________
9. House_____, townhouse_____, apartment______, other______________
10. Fenced yard? _____, type, size, height____________________________
Kennel run?_____, size___________, when used?__________________
11.Number of children in household (full and part time.) ______
ages and genders__________________________________________
12.Number of adults in the household (full and part time.)_____
ages and genders__________________________________________
13.Number of other dogs______, cats______
Breed, age, gender (spayed/neutered?) of dogs___________________
14.Primary caregiver of this dog___________________________________
15.How will this dog be exercised?_________________________________
16.Where will the dog stay at night?________________________________
17.Where will the dog stay during the day?___________________________
How many hours a day will your dog be alone?__________________
18.Will you use a tie-out, cable, or chain to restrain your dog outside?_____
19.Is there an adult home during the day?______________
20.Do you plan to take this dog to obedience training? ____
21.Do you own a pickup truck?______If so, where will the dog
ride?______________________________________________
22.Who will care for your dog in case of emergency? Vacation?
_________________________________________________________
23.Activities you participate in that will include your dog: hiking______
swimming_____, hunting_____, agility______, camping_____
other_____________________________________________
24.Your level of experience as a dog owner:
exp_____, somewhat exp_______; novice_______
25.Have you had previous experience with rescue dogs? _____ If so, please
explain:________________________________________________
26.Do you intend to provide your dog with a loving home for the rest of his
life?______________________________________
27.What characteristics do you expect of this dog?_________________
28.Under what circumstances would you consider surrendering your dog?
29.Do you prefer male_____, female______, no preference_______
30.What age range do you prefer?_______________________
31.Preferred temperament: mellow______, moderate energy_______
playful_________, active_________
32.Would you consider a special needs dog such as one that requires daily
medication?_______________
33.Are you prepared to adopt: now_______, later________(date)________
34.Do you agree to a home check?__________
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 Aussie Rescue asks for a rescue donation of $300-450 to help cover the costs of spay/neuter, vaccinations, heartworm test, microchip ID, and other office, foster and transport costs we incur. Submission of your application does not guarantee placement of a dog. Applicants must agree to a home visit if asked for one. The rescue donation is due at the time of placement.
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. Wyoming 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____________
Copyright © 2019 Western Australian Shepherd Rescue * All Rights Reserved
Western Aussie Rescue
APPLICATION FOR CANINE GUARDIANSHIP
return by email: westernaussierescue@gmail.com
1. Name (guardian)__________________________________
2. Dog interested in _________________________
3. Address____________________,______________,_____, zip___________
4. Home phone___________________, Work phone_________________,
Cell phone____________________, email________________________
5. Occupation/employer_________________________________________
6. Veterinarian reference _____________________phone______________
7. Personal reference_______________________phone________________
8. Rent/own? _______, Landlord___________________phone__________
9. House_____, townhouse_____, apartment______, other______________
10. Fenced yard? _____, type, size, height____________________________
Kennel run?_____, size___________, when used?__________________
11.Number of children in household (full and part time.) ______
ages and genders__________________________________________
12.Number of adults in the household (full and part time.)_____
ages and genders__________________________________________
13.Number of other dogs______, cats______
Breed, age, gender (spayed/neutered?) of dogs___________________
14.Primary caregiver of this dog___________________________________
15.How will this dog be exercised?_________________________________
16.Where will the dog stay at night?________________________________
17.Where will the dog stay during the day?___________________________
How many hours a day will your dog be alone?__________________
18.Will you use a tie-out, cable, or chain to restrain your dog outside?_____
19.Is there an adult home during the day?______________
20.Do you plan to take this dog to obedience training? ____
21.Do you own a pickup truck?______If so, where will the dog
ride?______________________________________________
22.Who will care for your dog in case of emergency? Vacation?
_________________________________________________________
23.Activities you participate in that will include your dog: hiking______
swimming_____, hunting_____, agility______, camping_____
other_____________________________________________
24.Your level of experience as a dog owner:
exp_____, somewhat exp_______; novice_______
25.Have you had previous experience with rescue dogs? _____ If so, please
explain:________________________________________________
26.Do you intend to provide your dog with a loving home for the rest of his
life?______________________________________
27.What characteristics do you expect of this dog?_________________
28.Under what circumstances would you consider surrendering your dog?
29.Do you prefer male_____, female______, no preference_______
30.What age range do you prefer?_______________________
31.Preferred temperament: mellow______, moderate energy_______
playful_________, active_________
32.Would you consider a special needs dog such as one that requires daily
medication?_______________
33.Are you prepared to adopt: now_______, later________(date)________
34.Do you agree to a home check?__________
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 Aussie Rescue asks for a rescue donation of $300-450 to help cover the costs of spay/neuter, vaccinations, heartworm test, microchip ID, and other office, foster and transport costs we incur. Submission of your application does not guarantee placement of a dog. Applicants must agree to a home visit if asked for one. The rescue donation is due at the time of placement.
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. Wyoming 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____________
Copyright © 2019 Western Australian Shepherd Rescue * All Rights Reserved