Type of dog applying for:
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Your Name
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First Name
Last Name
Phone Number
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Secondary Phone Number
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Address
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City
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State
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Zip Code
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Have you adopted from WMAS before? If yes, please provide the type of pet and name.
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Have you adopted a shelter pet before?
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Yes
No
Are you over the age of 21?
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Yes
No
Number and age of children living in the home
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Do you own your own home? If no, please provide the name and contact number for your landlord.
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Is your yard completely fenced in?
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Yes
No
Please provide information about your fence (height, material). If you do not have a fence, please explain how you will keep the dog contained on your property.
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Where will the animal primarily be kept?
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Indoors
Outdoors
Indoors mostly and outside on nice days
How many hours a day will the dog be left unattended?
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Are you going to crate train?
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Yes
No
Are you financially prepared for any unexpected expenses such as an emergency clinic or chronic illness?
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Yes
No
Give a detailed explanation of why you want the particular breed you are applying for.
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Do you have any cats or small animals in the home? Please explain.
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Have you ever given up an animal? If yes, when and why?
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Who will be the primary caretaker of this dog for feedings, veterinary visits, grooming, and purchasing supplies?
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How do you plan to integrate this dog into your family?
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Do you currently have any pets? If yes, please give name, breed, age, sex, if they are spayed/neutered, up to date on vaccinations, and on heartworm preventative.
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Please list any pets you have had in the last 10 years. Please give name, breed, age, sex, if they were spayed/neutered, and why they are no longer with you.
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Please provide the name and contact number for your vet
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Under whose name are the animal's medical records listed under?
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Are your dogs on monthly preventative for heartworms? List the brand of preventative.
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Any additional information you would like to provide.
