Application For Adoption

So that WEE BAR NONE RANCH Pet Placement may best assist you in the selection of a companion animal, we request that you complete this Application For Adoption in its entirety and submit it. It is our goal to find just the right pet for you, and just the right owner for the pet. Your completing this form is essential in that regard.

If you have any questions, please send us an email addressed to: wbnr@earthlink.net.

In order to be considered as an adopter you must:

  • be 21 years of age or older.

  • have identification showing your current address.

  • have the knowledge and consent of your landlord, if applicable.

  • be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet.

  • ensure loving care for the lifetime of the pet.

Thank you for participating in the rescue and adoption of a homeless animal!

0)

Please check the following option to signify that you have read and understand that completion of this form DOES NOT guarantee adoption of a WEE BAR NONE RANCH Pet Placement companion animal.

Application DOES NOT guarantee adoption.
I understand and agree.
1) Please list the pet(s) you are interested in:
2) Name of Applicant:
3) Street Address:
4) City:
5) State:
6)
 Zip:
7)
Phone:
    
  Home:
  Work: 
  Cell:  
8)
Email: 
9)
21 years old or over: Yes No
10)

Describe in as much detail as possible the animal you are looking for:

Note: We always have or know of more animals available for adoption than we have on our Internet adoption sites. We often are able to inform prospective adopters of additional animals that might fit the profile of what they are looking for. Please be as specific as possible. We may be able to refer you if we cannot match you with one of our companions.
11) Would this be your first pet? Yes No
12) What kinds of pets have you had in the past?
13) Which of these do you still have? (Include age, sex and breed.)
14)
 Have they been spayed or neutered?
Yes No Unsure Not applicable
15)
 Are they current on vaccinations?
Yes No Unsure Not applicable
16)
 What happened to the pets you no longer have?
Gave away
Sold
Took to shelter Explain:
Ran away
Died Cause of death:
Had euthanized by veterinarian
Reason:
Other Explain:
17)
 If you currently have pets, will they (or it) adjust to a new pet? Yes No
18)
 Have you ever had a animal obedience trained? Yes No
19)
 Why do you want this animal?
Companion Companion for another pet
House pet Watch dog
Guard dog Personal protection
Hunting As a gift for someone else
Other Explain:

20)

 How many adults are there in your family, and how do they feel about your adopting an animal?
21)
 How many children are there in your family and what are their ages?
22)
 Does any member of your household have an allergy to animals? Yes No
23)
 Is someone home during the day? Yes No
  If yes, whom?
24) Please explain how many hours each day the animal will be without human companionship:
25) Which do you live in?
  House      Apartment      Condo
  Mobile Home
        In a Mobile Home Park? Yes No
  Other Explain:
26) Do you own or rent your home? Own Rent
  If you rent, may we contact the owner to obtain permission for this animal to live in your home? Yes No
  Owner’s name and phone number:
27) Do you have a completely fenced yard to which the animal would have access? Yes No
  If yes, what kind of fence?
  Height:
  Is there a gate? Yes No
  If yes, does the gate have a padlock? Yes No
  If yes, do you keep it locked? Always Never Sometimes
  If no gate, explain:
  What size is the yard?
28) Describe the shade in the yard for the animal:
29) Is there a pet door from the yard into the house? Yes No
  If there is not a dog door, would you be willing to install one? Yes No
30) Do you have a pool? Yes No
  If yes, will the animal have access to the pool? Yes No
  What method would you use to introduce the animal to the pool?
  Is the pool totally fenced? Yes No
31) Are there times when the animal will be tied up? Yes No
  If yes, explain when, why, and for how long:
32) Are there times when the animal will be put in a kennel or dog run on your property? Yes No
  If yes, explain when, why, and for how long:
33) If your new companion animal is not housebroken, what method will you use to train it?

34)
Do you have a veterinarian? Yes No
 
If yes, Name:
  Address:
  City:
  State:
 Zip:
  Phone:
  May we contact him/her as a reference? Yes No
35) Will you keep the pet’s vaccinations up to date? Yes No
36) Would paying for unexpected medical costs present a financial problem for you? Yes No
  Many pet owners have found pet health insurance to be a great asset. When adopting through our page on Petfinder.com, you will be offered one free month of insurance at no charge so that you can evaluate the possibility of obtaining pet health insurance.
37) Would you be able and willing to exercise the animal on a regular basis?
Yes No
  If yes, exercise method:
38) Where will this animal be kept during the day?
39) Where will this animal be kept during the night?
40) If you drive a pickup truck, would you allow the animal to ride in the back?
Yes No
41) If you go away for a few days, or on a vacation, who will take care of the animal?
42) What would happen to the animal if you find you must move?
(Please contact us if you need assistance, giving us as much time as possible.)
43) Would you be willing to allow our representative to visit your home prior to placement? Yes No
44) Are you willing to make a lifetime commitment to taking responsibility for this animal? Yes No
45) What provisions will you make for the animal should you be unable to care for it?
Please keep in mind WBNR needs to be advised if such difficulties arise, as we will oversee future placement of pet, including follow-through of any suggestions you may have.
46) Comments by applicant:

47) Please list two personal references and their relationship to you:
  Name #1:
  Relationship:
  Phone:
  Name #2:
  Relationship:
  Phone:

Is there anything else you would like to tell us about yourself?

By entering your name below and clicking the "Send Form" button, you certify that all of the information you provide in this application for adoption is true and correct, and that if any of the information changes, you will advise WEE BAR NONE RANCH Pet Placement promptly.

Name:

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