Adoption Application

Arkansas Weimaraner Rescue

Individual or Couple Applying? *	Individual Couple
Primary Applicant's First Name *
Primary Applicant's Last Name *
Secondary Applicant's First Name *
Secondary Applicant's Last Name *
Address *
City *
State *	AR AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip Code *
Primary Applicant's Phone Number *
Primary Applicant's Email Address * Please enter correctly as this is the main way we will contact you
Secondary Applicant's Phone Number *
Secondary Applicant's Email Address
Do you have a sex preference?	Any Female Male
Do you have an age preference?	Any Young Adult Senior
Which AWR rescue are you interested in?	Buddy (Dog - D2411082) Orbit (Dog - D2411085) Ringo (Dog - D2411084)
How did you hear about AWR? (Petfinder, DogWatch, etc) *
Why do you want to own a Weimaraner? *
If you have other pets, please describe them. (Age, sex, personality, etc)
What pets have you had in the last 5 years? What happened to them (if they are no longer with you)? *
How many people live in the house where the dog will stay? (List ages of each) *
Describe the area in which the dog will live. (Rural, Neighborhood, Inside, Outside, etc) *
Is your yard fenced in? *	NoYes
Please give height and type of fence. *
If you rent, do you have permission from your landlord to have pets? *	Unsure Yes No N/A
Where will the dog stay during the day? Night? Vacations? *
Do you use heart worm prevention and flea/tick prevention? If so, what kind? *
Approximately how many hours during the day will the dog be left alone? *
Is your current pet(s) spayed/neutered? *
Do you promise to notify the Weimaraner Rescue of Arkansas if you cannot keep your Weimaraner? *	NoYes
Are you willing to take your dog to obedience classes? *	NoYes
What are the occupations of the working members of your household? *
What plans do you have, for the animals, in the event something tragic should happen in the family? Is this in a written document or will? *
Vet Office Name you want us to call for a reference? * If you have never owned a pet please tell us where you would go.
Vet Office phone number? *
Are the records at the Vet Clinic in your name or someone else’s?	Mine Someone else
Please give the FIRST & LAST Name of the person the records are under at the vet clinic. *
Please list a personal reference (Name and Phone Number), other than a family member, who we may call. *
Please list a 2nd personal reference (Name and Phone Number), other than a family member, who we may call. *
Please list a 3rd personal reference (Name and Phone Number), other than a family member, who we may call. *
Our rescue dogs are all spayed or neutered, current on vaccinations and come with a 2 month supply of heartworm prevention. Weimaraner Rescue is a non-profit organization and we do charge an adoption fee to offset our expenses. The fee is usually between $150 and $400. You also agree by submitting you will be added to our mass emailing list.
Do you agree to the above? *	NoYes

Please click Submit ONLY ONCE to submit form to Arkansas Weimaraner Rescue. If you do not receive a confirmation email after you hit Submit, please re-submit your application.