ATRA Adoption Application - Abandoned Terrier Rescue Association

Do you desire to foster or adopt a Wire Fox Terrier?

Foster
Adopt
Other, I’d like to have a conversation about fostering or adopting.

Applicant Name

First

Last

Applicant Phone

Applicant Email

Street Address

City, State, Zip

Occupation

Type of Work

Full time
Part time

Does your job require frequent travel?

Yes
No

Are you subject to relocation?

Yes
No

Is there an adult co-applicant that lives with you?

Yes (If yes, please proceed with next question)
No (If no, please jump to YOUR SITUATION ========)

Co-Applicant Name

First

Last

Co-Applicant Phone

Does the co-applicant's job require frequent travel?

Yes
No

Is the co-applicant subject to relocation?

Yes
No

YOUR SITUATION ======== What arrangements will be made for your dog during extended absences? (Please check any that apply)

have yard? you

You are:

Check the option that captures your general age

Check the option that captures your general place of residence

Do you own or rent?

Own
Rent
Other

And how long (about) have you lived at your current residence

If you rent, do you have permission from the landlord to have a dog

Yes
No

Please provide the landlord's name and phone number

Is your yard completely fenced?

Yes
No

What is the fence height?

up to 3′
4′
5′
6′ or higher

What is the fence type?

If "something else" please explain

Is there a doggie door to the yard?

Yes
No

Is there a pool or spa in the yard?

Yes
No

Is there is a pool or spa in the yard, is it separately fenced?

Yes
No

Is there is a pool or spa in the yard, is it separately fenced? (copy)

Yes
No

Please list your household members' names and ages

Do you have frequent visitors? If yes, please provide an idea of how many, the range of ages and the regularity of visits.

Are you planning on adding to the family in the future?

Yes
No

Do any family members have allergies to dogs

Yes
No

Please provide an outline characterizing your daily activities.

PREVIOUS EXPERIENCE AND PET INFORMATION ======== Thinking of your lifestyle, what qualities in a dog would be ideal for you?

How long will your dog be left alone daily?

Where will your dog be when alone?

Where will your dog sleep at night?

Do you have knowledge / experience with (please check any that apply)

Grooming needs of a WFT
House training
Obedience training
Crate training

If you have experience with crate training, please indicate when and how the crate was used.

How would you handle behavioral issues such as accident in the house, chewing, or general misbehavior?

Currently, do you have any other animals or livestock?

Yes
No

If yes, please indicate breed, sex, age, neuter/spay info for dogs

Do you currently have another dog?

Yes
No

If the dog has health issues, please explain.

Has the current dog ever lived with another dog?

Yes
No

Is the current dog your only dog?

Yes
No

How long has the current dog been your only dog?

Please list any dogs that visit frequently and indicate their breed and if they are spayed/neutered.

Describe previous dogs in your life and indicate for each: 1) breed; 2) gender; 3) how long they lived with you; 4) how they passed away; 5) where you obtained the dog.

If you have ever sold, given away or otherwise surrendered a pet to a shelter or rescue, please explain the circumstances. If not applicable, enter "NA."

Have you ever had a dog run away that had to be reclaimed from a shelter?

Yes
No

If you had a previous veterinarian, provide contact information ATRA may use as a reference. (Name, phone, address, city, state)

ADOPTION INFORMATION ======== Why are you interested in a Wire Fox terrier or other dog we may have?

If you have any breed preferences for dogs, other than Wire Fox Terriers, please list breed types or type "NA."

If you have a gender preference, please list the gender type and why you feel you have that preference. Otherwise, type "NA."

If you have an age preference, please list the age you are interested and why you feel you have that preference. Otherwise, type "NA."

Do you have any temperament preferences? If so, please list you preferences. Otherwise, type "NA."

Would you adopt a Wire Fox Terrier or other breed with minor health issues?

Yes
No
Depends on the type of health issue

Have you ever adopted from a Rescue?

No
I’ve adopted from ATRA
I’ve adopted from a shelter
I’ve adopted from elsewhere (please explain in next field)

If you adopted from elsewhere, please explain. Otherwise, type "NA."

When will you be ready to adopt? (If ready now, type "immediately;" if another date, please indicate the date.

Are you willing to have a rescue volunteer conduct a scheduled home visit prior to adoption?

Yes
No

How did you hear about The Abandoned Terrier Rescue Association (ATRA)?

Have you visited our website at ATRARescue.com or our Facebook page?

Yes, I’ve visited your website
Yes, I’ve visited your Facebook page

All rescues are spayed and neutered prior to adoption. An adoption contract is required. We are a 501(c)(3) non-profit organization relying on donations to continue our mission of rescuing, rehabilitating and rehoming Wires in need. Therefore, we respectfully request a $500 donation prior to adopting. All donations go directly to the care of the dogs and help to defray veterinary, transportation and other costs. By submitting this application for review, the applicant certifies that the information provided is accurate. If we determine that a material misrepresentation has been made, applicant understands that it will void this application from any consideration. Applicant understands that providing proper grooming, food and veterinary care can be costly but applicant represents that (s)he is physically and financially capable of providing for an adopted dog.

Your Full Name

By entering your name, the date and submitting this form, you are indicating that you understand the above.

Today's Date

If you have further questions, call: 951 233 0155. Thank you for your interest in adopting!