GLWR ADOPTION APPLICATION

GREAT LAKES WESTIE RESCUE, INC. ADOPTION APPLICATION
Great Lakes Westie Rescue, Inc. is a not-for-profit corporation in the state of Indiana. Below is our mission statement. Please read and understand that the adoption fee requested is used solely for the purpose of meeting the enormous expenses involved in providing the services of: intakes, transporting, veterinary care, fostering, rehabilitation/retraining, and placement of these Westies.

Mission Statement

The purpose of the Great Lakes Westie Rescue, Inc. (GLWR, Inc.) is to provide rescue activities and services for West Highland White Terriers from shelters, breeding facilities, auctions, owner surrendered, and any other Westie finding itself in need of such services. GLWR, Inc.'s provided activities and services include, but are not limited to: pick up and transport of Westies; evaluation of Westies; fostering, rehabilitation and training of Westies; soliciting and screening of adoptive permanent homes and placement in approved homes; and the education of the public about the nature of the Westie and responsible Westie care and ownership.
APPLICANT:
Full Name:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number
E-mail
Age:
Occupation:
CO-APPLICANT

First NameLast Name
Age:
Occupation:
Relationship:

DESIRED WESTIE:
Preferred Gender:

MaleFemaleNo Preference
Preferred Age:
Willing to house train?

YESNO
Willing to take a special needs Westie?

YESNO
Have you ever owned a Westie or terrier breed?

YESNO
Why do you want to adopt a Westie?

HOME ENVIRONMENT
Do you live in a:
Do you:

RentOwn
How long have you lived at the present address?
Do you have a securely fenced in yard? (An electric fence is not considered to be secure.)

YESNO
If YES, what type of fence do you have?
If you do not have a secure fence how will this Westie be exercised?
How many adults live in the home?
How many children live in the home?

Please list the ages of the children in the home:
Who will be the primary caretaker of the Westie?
Does the caretaker have experience with terriers?

YESNO
Is there anyone home in the caretakers absence? Who?
This Westie will be left alone how many hours daily?
This Westie will be left alone how many hours in the evening?
Where will this Westie be kept when left alone?
Where will this Westie sleep at night?
Please list and describe the other pets in this household:
Are you a first time dog owner?

COMMITMENT
All Westies must be spayed/neutered. Do you agree to do so if necessary?

YESNO
Are you willing/able to provide veterinary care for the life of this Westie?

YESNO
Are you willing/able to assume responsibility for the Westie for life?

YESNO
If you could no longer keep this Westie, do you agree to notify GLWR, Inc. and return the Westie to rescue as agreed upon in the Adoption Contract?

YESNO
Have you ever had a pet die at an early age or due to an accident? Please give details:

REFERENCES: GLWR, Inc. requires a veterinarian reference and two personal references that are unrelated to the applicant(s).
Please provide the Name, Address, and Phone Number of your Veterianarian and authorize them to speak with us:
1) Please give the Name, Address, and Phone Number of a personal reference that is unrelatd to you:
2) Please give the Name, Address, and Phone Number of a personal reference that is unrelated to you:
Is there any other information that you would like us to know regarding your application to adopt a Westie from GLWR, Inc.?
Have you completed and application to adopt from any other Westie Rescues?
THANK YOU for applying to adopt a Westie from GLWR, Inc. We will screen your application against the list of Westies that we have available for adoption. IF we have a match we will contact your references and vet and then contact you to arrange a home visit.. IF you do not hear from us right away we do not have a match for you at this time but will retain your application on our active list and match your criteria against each Westie coming into our rescue. When a match is found we will contact you. Thank you again and we look forward to working with you when one of our Westies is matched to your home.
Should be Empty: