Application

Please complete this application in order to begin the adoption process. All applications must be approved prior to placement. It is very important that you answer all the questions honestly so that we can place a dog in your home that will become a permanent family member. Some animals we rescue are great with kids, some are better with just adults. Some do well outside, others do not, however, we do not adopt to homes that will keep a dog outdoors to live. Our dogs are house-dogs, to be made part of your family. Your honest answers will help us place a dog that is good for your particular circumstances. Please contact us if you have any questions.

This application is quite extensive and in-depth, however, do not let this discourage you from completing it and returning it to us!

Note that there is an adoption donation required, that varies depending on the cost of the following:

~ Shelter break out fee
~ Rabies vaccination
~ DHLPPC annual booster shots
~ Heartworm check (or treatment)
~ Dental work
~ Other necessary medical treatment
~ Heartworm preventative
~ Spay/neuter charge

All of the above will be taken care of prior to adoption. You should, however, still consider taking the dog to your veterinarian upon adoption.

We genuinely care about the welfare of all adoptive animals, therefore, it is standard procedure to do a home check as part of the application process prior to placing an adoptable animal in a new home. We also check references as part of our process.

Adopting a rescued dog is sometimes quite different than bringing home a brand new puppy. Sometimes our rescued dogs come from great homes where they have received lots of TLC, but for one reason or another, the family cannot keep them. Sometimes the dog has been a stray for some time, been in a shelter, or not been in the best of homes. We do not adopt out an aggressive dog. We try to do our best to work through “trust issues” with the dogs rather than euthanasia. When you adopt a rescued dog, there will be a period of adjustment for both human and pet. Lots of understanding, quiet time, and bonding with one or two family members. We will be able to help you with specifics at the time of adoption, but do keep in mind that adopting a rescued dog can be challenging. We hope to hear from you soon and thank you for choosing adoption!

When filling out this application, please use the "TAB" key or mouse to move from one field to the other. Do NOT use the "return key", it will end the application process and send before you are finished.

Date:
mm/dd/yy

Your name:

Email address:

Street address:

City:
State: Zip

Telephone:
Home: Work: Cell:

Name of Dog
Primary Breed Secondary Breed

(Please feel free to expand on any of these questions.)

Have you owned dogs in the past? yes/no

Where are these animals now? Please elaborate.

For whom (family member) are you adopting?

Name and ages of all family/household members:

Do you often have other people visiting your home? yes/no
Grandchildren? yes/no Other children? yes/no

Is everyone in the residence and family agreeable to adopting a rescued dog? yes/no

Are you willing to teach young children the proper care and treatment of this dog? yes/no

Are you willing to always monitor young children with this dog? Even a rescued dog that has proven reliable around young children? yes/no

Are you willing to:

Take the dog to a veterinarian at least once a year for a physical exam, shots, and heartworm check if heartworm check is required by your vet each year? yes/no

Take the dog to a veterinarian when sick or injured? yes/no

Welcome the dog into your family as a permanent member? yes/no

Return the dog ONLY to a West Kentucky Rescue (WKR) representative if you decide that he/she cannot be a member of your family? yes/no

Maintain heartworm preventative medications throughout the dog’s life? yes/no

Do everything in your power, and with the help of your veterinarian, and /or other professionals to ensure that the dog has a long, healthy life? yes/no

Have you given careful consideration to the following:

Financial obligations of responsible pet ownership? yes/no

Special needs and time and patience involved with a new pet in the home? yes/no

Who will care for the dog and where will the dog be kept?

Why do you want to adopt a rescued dog at this time?

Do you currently own any other pets? Please list the name, species, breed, age of each:

Type of residence: House/condo/apartment/mobile home own or rent:
      If renting, is landlord agreeable to you having a dog?
      If renting, a signed statement from your landlord must be received prior to adoption.
      If renting, landlord name, address, email and phone number:


Do you have a yard? yes/no
      fenced? yes/no type of fence: height of fence:
How will you exercise the dog?

Where will the dog be kept during the day?

How many hours a day will the dog be left at home alone?

Where will the dog sleep?

Who will take care of the dog while you work?

Would you be willing to take the dog for obedience training if needed?

What do you intend to feed the dog?

REFERENCES:

Vet: Please list the name, address, email, and phone number of your veterinarian:

Groomer: Please list the name, address, email, and phone number of your groomer:

Personal References: Please give 3 names, addresses, phone numbers and and email addresses of personal references that are NOT related to you or living in your home
1
2
3

Your place of employment:
      Occupation:
      Work address:
      Work phone number:

Spouse place of employment
      Occupation:
      Work address:
      Work phone number:

Do you have any further comments you would care to make?

By typing your name below, you signify that you have filed this application, and understand all that is contained within. Before the adoption, you will be required to sign an adoption contract.

The information provided in this application is true to the best of my knowledge as of the date on this application.
Electronic Signature:

Submission of this application in no way guarantees that you
will receive a dog from West Kentucky Rescue.

Application Form