Pet Adoption Application Form

Wilson Dog Rescue

903-818-1450, 918-223-5966. Email: wilsondogrescue@gmail.com
Adoption Application, Contract and Waiver
Name of Pet You Wish to Adopt*
Perspective Pet Parent*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you own any pets?*
Pet Name(s)
Pet Breed(s)
Pet's disposition and behavior towards other dogs?
Please provide your veterinarian's name and phone number:
Do you own or rent your home?*

OwnRent
What is your landlord's pet policy?*
If you rent, please provide your landlord's information here:*
Do you have a yard?*

YesNo
If "Yes" to the above, is it fenced? please describe
Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*

YesNo
Are there children in the home? (If yes, please list ages)*
If you answered "Yes" to the above question, please provide detail:
How many hours per day would the pet be alone?*
Will you crate your pet?*
If you have to leave town, emergently or planned, where would your pet stay?*
How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*
Please provide the names, emails, and contact numbers for 3 personal references:*
Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo
If you answered "Yes" please provide a detailed description:
- By clicking the submit button, I agree to Wilson Dog Rescue's adoption process, will undergo a homecheck, and interview at the discretion of Wilson Dog Rescue.
- By clicking the submit button, I understand Wilson Dog Rescue. will check my references including veterinary and personal.
- By clicking the submit button, I understnd that there is an adoption fee associated with adoption of a pet from Wilson Dog Rescue.
- By clicking the submit button, I agree to indemnify and hold harmless Wilson Dog Rescue.. against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
- By clicking the submit button, I understand that Wilson Dog Rescue.. will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
- By clicking the submit button, I understand that I have 3 days, from date of pay, to change my mind and seek refund. After that point, there shall be no refund unless the adopted pet passes away. If that should happen, I can be refunded or I can select a new dog.
- By clicking the submit button, I verify all of the above information is true and accurate.
Signature of Potential Pet Parent*

Clear
Take PhotoPlease take a picture of your state legal license or ID. This is to provide proof of the person signing this document. Please note that this will not be shared with any other person. We respect your privacy*
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty:

Wilson Dog Rescue