Family Profile and Adoption Application

Thank you for your interest in Maryland Westie Rescue. Please answer the following questions so that we may evaluate and select the correct dog for you. All information is confidential. Please note that at any time during the application process we determine that any of your responses are misleading or less than truthful, your application will not be considered further. Also, please take care to ensure that the application is completed in full before you hit the submit button inasmuch as incomplete applications will not be considered.

Generally, the adoption contributions are $350.00, but may be higher or lower depending on the age and condition of the particular Westie..

MWR reserves the right to modify the above amounts at any time without notice.

Our dogs are fully vetted before they are placed into adoptive homes (there are some exceptions due to health and/or age). They will be neutered/spayed, brought up to date on their vaccinations, tested for heartworms, and may have a dental cleaning. And in most cases, our costs exceed the adoption donation amount we get for the dog.

Please note: We are not accepting applications from applicants with the following:

  • Children under 8 years old
  • Any sort of electric/invisible fencing
  • Any current pets (dogs/cats) that are not spayed or neutered
  • Any current pets (dogs/cats) that live outside
  • Tethers/tie outs

REMINDER: IT IS IMPORTANT TO ANSWER EVERY QUESTION. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED



 

If you are applying for a specific dog, please enter the dog's name here:
If the above dog is no longer available, do you wish to remain on our waiting list to adopt? Yes
No
Applicant Information:
Name of Applicant:
Name of Spouse or Co-applicant:
Relationship of Co-Applicant to Applicant:
Address:
City:
State:
Zipcode:
Home Phone:
Work Phone (optional):
Cell Phone (optional):
Applicant's E-mail:
Co-applicant's E-mail:
Applicant's Age:
Co-applicant's Age:
Applicant's Employer:
Co-applicant's Employer:
Please tell us why you want a Westie as opposed to another breed of dog? What is it about Westies that you like? [NOTE: THIS QUESTION IS IMPORTANT]:

Does your job require frequent out-of-town travel? Yes
No
If yes, who will care for the dog when you travel?:
Is your job subject to relocations? Yes
No
Household Data: Single
Married
Sharing Home with Unrelated Adults
Number of Children in Household (include sex and age) or grandchildren (or other children) that regularly visit.
Do you own or rent?: Own
Rent
Residence Type: House
Townhouse
Condo
Apartment
Other
Do you have a securely fenced yard? If yes, what type of fencing?
Do you have a pool, outdoor hot tub or water feature (e.g., decorative fish pond)? If yes, is it fenced separately?

Tell us about your pets:
Have you ever owned a dog? Yes
No
If yes, what breeds?
Do you still own a dog(s)? Yes
No
If yes, it he/she spayed/neutered? Yes
No
If any of your current pets are not spayed/neutered, please explain why:
Where is the present dog(s) housed? (Inside, outside, both) Please describe:
What happened to dogs no longer in your care?
List all pets currently in your home. Include Breed, Sex, Age, and how long you've had the pet:
Pet 1:
Pet 2:
Pet 3:
Pet 4:
Pet 5:
Pet 6:
Are all of your pets current on their vaccinations? Yes
No
Name, Address and Phone Number of your Veterinarian (or the one you plan to use):
How long have you used this Veterinarian?

Desired Westie:
Gender of desired Westie Male only
Male - but will consider a female
Female only
Female - but will consider a male
No preference
Preferred Age of Westie: Puppy
Under 3 years old
Under 5 years old
Under 8 years old
No age preference
If no age preference, would you be willing to consider a Westie age 8 years old or older? Yes
No
Would you consider a pair of Westies if they became available? Yes
No
Would you consider a Westie-Mix? Yes
No
Are you willing to housetrain? (Please be honest. If you check "yes" and we contact you about a Westie that is not housetrained and you decline because you don't want to housetrain, you will not be considered for another Westie.) Yes
No
Are you willing to consider a Westie with slight health problems? Yes
No
Not sure, but willing to discuss
Will you consider a Westie we've rescued directly from a puppy-mill? These dogs will require extra attention, including housetraining, learning to walk on a leash, learning to play with toys, learning not to be fearful of humans, etc. (Please be honest if you would rather not.) Yes
No
Not sure, but willing to discuss
Who will be the primary care giver of the adopted Westie?
How long will the Westie be alone each day?
How long will the Westie be alone each evening?
Where/how will the Westie be housed when left alone?
Where will the Westie sleep at night?
Will the Westie be allowed on the furniture? Yes
No
Have you considered the length of commitment (Westies can live 15+ years)? Yes
No
Have you considered the annual expenses of vaccination, food, grooming, etc.? Yes
No

References:
List two personal references not related to you and how long you have known them:
Reference 1
Name and Address:
Telephone Number(s)?
How long have you known this reference?
Reference 2
Name and Address:
Telephone Number(s)?
How long have you known this reference?
Additional comments or information you would like to share with us. Please notate in this section if you are interested in a particular dog(s):


Considerations to note:
  • Applicant understands that the rescue dog will be spayed or neutered (either by Maryland Westie Rescue or the applicant, depending upon the circumstances and age of the dog).
  • Applicant understands that no form of registration (such as AKC papers) will come with the dog.
  • Applicant understands that it will be the applicant's responsibility to provide medical care, proper nutrition, shelter, and training for the rescue dog as long as it is in your care.
  • Applicant understands that at no time will applicant be permitted to rehome the rescue dog with anyone else without written permission from an authorized representative of Maryland Westie Rescue.

By submitting this electronic application, I certify that I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and/or sign the application can result in this application being denied. Also, if an omission or untruth is discovered after an adoption takes place, I understand that Maryland Westie Rescue reserves the right to annul the adoption and reclaim the dog. Should such a situation lead to legal process, I agree I am solely responsible for all costs, including attorney fees and court costs.

I have reviewed the Maryland Westie Rescue Adoption Agreement and am willing to agree to and comply with its provisions.

I understand that prior to being approved for adoption or temporary foster care in my home, all of the above information will be verified, and by signing this, I give my permission for this verification.

I agree to a home and yard visit if it is required and also to a personal interview with a member of this rescue effort or their agent to determine the suitability of my home to care for a dog.

I further agree that if at any time, in the opinion of Maryland Westie Rescue (or an agent), that it is to the benefit of the dog's well being to be removed from my care, I will relinquish said dog immediately and without negative indicent. Should such a situation lead to legal process, I agree I am solely responsible for all costs, including attorney fees and court costs.

Depending on the dog which I am adopting, I understand that the adoption cost is generally $350.00 and will go directly toward helping to offset medical costs associated with Maryland Westie Rescue's services.

I fully understand and agree to assume all risks involved in the adoption of a dog(s) from Maryland Westie Rescue, Inc. I agree to hold Maryland Westie Rescue, Inc., harmless and not responsible for any injury(s) that I might sustain resulting from the adoption. This waiver includes the above understanding for myself, all of my family members and the descendants of such forever from seeking any legal action whatsoever against Maryland Westie Rescue, Inc., or its representatives.

This application will expire 6 months from the date it is submitted and a new application will need to be submitted to remain on our waiting list at that time.







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