Today's Date *

Today's Date

YYYY

Which Dog Are You Interested In Adopting?

Name *

Name

The information below will be used to register your animal's microchip so please type carefully.

First Name

Last Name

Phone Number *

Phone Number

(###)

###

####

Secondary Phone Number

(###)

###

####

Email Address *

Our adoption counselors will send communications to the address you provide here and you may need to check your SPAM folder for emails from info@WineCountryAnimalLovers.org so you don't miss important next steps.

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Occupation *

Personal References

Please list someone who is familiar with you and your pets. Examples: landlord, veterinarian, pet sitter, etc.

Reference #1 *

Reference #1

First Name

Last Name

Relationship To You *

Phone Number *

Phone Number

(###)

###

####

Reference #2 *

Reference #2

First Name

Last Name

Relationship To You *

Phone Number *

Phone Number

(###)

###

####

Family & Housing

Please List ALL Humans Who Live In Your Home. Include their age and relationship to you. *

How Often Do Children Visit Your Home? *

What Type Of Home Do You Live In? *

Household Activity Level *

Give Us An Idea Of The Typical Week At Your House

Does Anyone In The Family Have A Known Allergy To Dogs? *

Is Everyone In Agreement With The Decision To Adopt A Dog? *

Do You Have Any Concerns About The Amount Of Time & Money It Takes To Adequately Care For A Dog? *

other pets

What Is Your Experience With Dogs? *

We're here to help, not judge! Don't be shy if this is your first dog or if you have limited experience.

Please List ALL Pets That You Share Your Home With. Include Their Type, Breed, Age & Sex *

Are All Of These Pets Spayed/Neutered? If Not, Why? *

Are All Of These Pets Up To Date On Shots/Vaccines? *

Are All Of These Pets Current On Heartworm Prevention & Flea/Tick Control? *

Have You Ever Had To Surrender A Pet To A Rescue Or Shelter? If So, Please Explain Why. *

veterinarian

Name 3 *

Name 3

First Name

Last Name

Clinic Name *

Clinic Location *

Clinic Phone *

Clinic Phone

(###)

###

####

Caring For Your New Dog

Who Will Be Responsible For Your Dog's Daily Care? *

Why Are You Interested In Adopting A Dog? *

Select All That Apply

House Pet/Companion

Companion For Other Pet In Home

Friend For My Child

Guard Dog

Personal Protection

Working Dog (Sports/Hunting/Ranch, etc.)

How Do You Plan On Exercising Your Dog? *

How Will You Train Your New Dog? *

Select All That Apply

DIY

Training Classes

Private Trainer

I Don't Plan On Training This Dog

What Type Of Training Methods Will You Use With Your New Dog? *

Please Give An Example

Describe Where Your New Dog Will Spend The Day *

Describe Where Your New Dog Will Spend The Night *

Does Your Home Have A Securely Fenced Yard? *

Does Your Home Have Electric / Invisible Perimeter Fencing? *

Do You Have Any Concerns With Your Ability To Keep This Dog Confined To Your Home & Yard? *

We're Here To Help, Not Judge! Please Let Us Know If You Have Concerns.

How Long On Average Will Your Dog Be Left Alone? *

Describe Where He/She Will Be Kept While You Are Away *

Do You Have The Financial Resources To Care For This Dog? *

This includes life-long veterinary care, pet-friendly housing, pet insurance, high-quality food, bedding, crate, toys, pet sitters/boarding, training and more!

Do You Agree To Provide Regular Health Care By A Licensed Veterinarian? *

What Would You Do If You Could No Longer Keep Or Care For This Dog? *

Do You Agree To Contact WCAL In The Event That You Can No Longer Keep This Dog? *

Are You Willing To Let A Representative Of WCAL Visit Your Home By Appointment? *

All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide proper and nutritious food, fresh water, indoor shelter, affection and kind treatment for the animal at all times. This dog will receive annual physical examinations and regular vaccinations under the supervision of a licensed Veterinarian. I understand that the animal I am adopting has already been sterilized and microchipped and I agree that once I adopt this new dog and bring it home, any medical bills incurred on behalf of this animal or any other animals in my home will be my responsibility. As with any dog, there is a chance that this dog could bite another dog or human and avoidance and training are highly recommended to ensure this doesn’t happen. As of the date below, I agree to assume complete responsibility and hold WCAL harmless and free of any liability related to this dog. *

Please Sign Below

THANK YOU!

We are an all volunteer group and we do our best to respond in a timely manner. You can expect a call or email from us within a few days. Please check your SPAM folder for emails from info@WineCountryAnimalLovers.org so you don’t miss next steps. Your patience is appreciated!

DOG ADOPTION APPLICATION

Ready to adopt one of our dogs or puppies? Fill out the form below to get started!

DOG ADOPTION FEE $150.00 (Fee will be waived if adopting a senior or special needs pet)
Your additional donations are tax deductible and will help WCAL to save more animals!

WCAL is here to support you and to promote a healthy relationship between you and your new pet. Please think of us as a resource and a partner. We encourage you to call us with any questions or concerns, and ask that you please respond to our follow up requests.

We are here to help!

DOG ADOPTION APPLICATION

Ready to adopt one of our dogs or puppies? Fill out the form below to get started!

DOG ADOPTION FEE $150.00 (Fee will be waived if adopting a senior or special needs pet)Your additional donations are tax deductible and will help WCAL to save more animals!

WCAL is here to support you and to promote a healthy relationship between you and your new pet. Please think of us as a resource and a partner. We encourage you to call us with any questions or concerns, and ask that you please respond to our follow up requests.

We are here to help!

DOG ADOPTION FEE $150.00 (Fee will be waived if adopting a senior or special needs pet)
Your additional donations are tax deductible and will help WCAL to save more animals!