Applicant

Name (Required)

Age (choose one) Under 21 21 and over

Address

City, State, Zip Code

Home Telephone (Required - including area code)


Cell Phone (including area code)


Email (Required)

Employer

Employer Telephone (including area code)

Co-Applicant

Name

Age (choose one) Under 21 21 and over

Employer

Telephone (including area code)

Relationship to Applicant

Desired Westie

What Westie are you Applying for (If you are applying to Foster, enter Foster Westies)?

Age of Westie
Check one:
No Preference
I prefer a dog no more than years old.
 

House-Training

No Preference I Prefer a dog that is house-trained I Require a dog that is house-trained

Would you Consider Adopting a Westie mix?

No Preference I Prefer a Pure-breed I Require a Pure-breed

Why do you want a Westie? (check all that apply)

Companion for Humans Companion for Current Pet Gift
To Breed For Children For Protection
Other

Your Home Type of Building
Apartment Condominium Duplex Townhouse Home
Other

How long have you lived there? Years

Do you have a totally fenced yard? YES NO
If yes, what type of fence?

Do you have a POOL HOT TUB
If yes, is it separated from the dog area by a fence? YES NO

How many people live in your home? Adults Children
Ages of children

Tell Us Your Plans

Who will be the dog's primary caregiver?

Does he/she have experience with dogs? YES NO

Is anyone home during the absence of the primary caregiver? YES NO

How long will the dog be without humans each day?  Evening?

Where will the dog be when home alone?
In a Crate In One Room In a Bedroom In the Basement
Loose in the House In the Yard
Other

Where will the dog sleep at night?
In a Crate In One Room In a Bedroom In the Basement
Loose in the House In the Yard
Other

How do you plan to exercise the dog?

Does your job require frequent out-of-town travel? YES NO
What is your care plan for travel times?

What will you do with the dog if you move?

May we visit your home? YES NO

Are you committed to caring for a dog for its lifespan? YES NO
(Westies can live as long as 17-18 years)

Are you willing and able to support a dog? YES NO
For a healthy dog, costs of veterinary care (shots, flea and heartworm preventative), food, toys and minimal boarding and grooming can cost $500-$700 per year.

We require all Westies to be spayed/neutered. Do you have any reservations about this policy? No Yes

Have you ever sold or given away a pet to anyone or surrendered one to a shelter? No Yes
If yes, please provide details.

Where would you house your new pet? Inside Outside Both
If Both, explain:
 

Have you ever lived with a Westie? Yes No

Have you ever owned a terrier? Yes No
If yes, which breed?

Have you ever trained a dog? Yes No
If yes, give details:

Personal References (If you do not list a minimum of 3 personal references your application will be automatically denied)

Please list three personal references (not related to you).
Include Name/Relationship/Phone Number (with area code)/Best Time to Call

Veterinary Reference (Please list your current vet or the one you have used most recently. If you have never used a vet, please state so in the Name of Veterinary Hospital field.)

Name of Veterinary Hospital

Doctor's Name

Phone (Including Area Code)

Address

City, State, Zip Code

Is this veterinarian familiar with pets you have owned? Yes No
Please list all pet's names:

May we contact the doctor as a reference? Yes No
If you answer No, please explain why:

PLEASE NOTE: At the time you adopt one of our rescue Westies, you will be asked to make a donation to Oklahoma Westie Rescue (OWR). This donation helps defray costs associated with caring for these dogs while they are with OWR. The requested adoption donation for our dogs is $250 per dog.

We do not ship our pets. Be prepared to travel to Tulsa, OK, or Oklahoma City, OK, to pick up the dog(s) in person if your application is approved.

Your signature(s) will be required on a formal Adoption Contract prior to adopting any rescue dog.

Please make sure the application is complete and you have entered your e-mail address and current phone numbers before pressing the "Submit" button below.

The information I have provided is accurate and complete. I understand that any misrepresentation of facts may result in removal of the adopted dog by Oklahoma Westie Rescue.