West Coast Airedale Rescue
Adoption Application
Date of Application:
Contact Info
First Name
Last Name
Street Address
City
State
Zip
Cell Phone
Home Phone
Email
1. Applicant Age:
2. Does applicant mobile phone receive texts?
Yes
No
No mobile phone
Other
If other, explain:
3. Are you employed?
Yes
No
Other
If other, explain:
4. If employed, name and address of employer:
5. Employer primary telephone number:
6. Does primary phone accept text?
Yes
No
No mobile phone
Other
If other, explain:
7. Spouse/Significant Other Name:
8. Spouse/Significant Other Mobile Phone:
9. Does Spouse/Significant Other Mobile Phone accept text?
Yes
No
Other
If other, explain:
10. Spouse/Significant Other Email:
11. Spouse/Significant Other Age:
12. Is Spouse/Significant Other employed?
Yes
No
Other
If other, explain:
13. If Spouse/Significant Other is employed, name and address of employer
14. Mailing address (if different from physical address)
15. Are you willing to have a rescue volunteer visit your residence by appointment both before and after adoption?
Yes
No
Other
If other, explain:
16. Any other people living in the household?
Yes
No
17. Do you have frequent visitors?
Yes
No
18. Do you plan to add to your family in the next five years?
Yes
No
19. Do you currently own any dogs?
Yes
No
If yes, breed, size, age, male or female, intact or neutered, how s/he gets along with other dogs, any medical conditions?
20. Do you own any indoor pets other than dogs?
Yes
No
If yes, please describe:
21. Are you aware that some Airedales kill cats and will never be able to live with a cat?
Yes
No
22. How often do dogs visit your home?
Often
Infrequently
Never
Other
23. Do you have any outdoor animals?
Yes
No
If yes, how are they contained:
24. Does anyone in your household have allergies to animals?
Yes
No
If yes, please describe:
25. Why do you want an Airedale Terrier?
26. Do all family members want an Airedale Terrier?
Yes
No
If no, describe who and why not:
27. Describe your family's typical day and how your dog(s) fit into that day:
28. If this your first Airedale?
Yes - First Airedale
No - Currently own an Airedale
No - Have previously owned an Airedale
29. Are you aware of Airedale grooming needs and expenses?
Yes
No
30. Do you realize that Airedales are infamous for the water and mud they carry in their beards?
Yes
No
Describe other dogs you have owned and how long you have owned them:
31. Have any of the dogs you have owned as an adult had behavior problems? If so, please describe how you handled the issues. If you have not owned a dog as an adult, please state that. If none of the dogs you have owned as an adult have had any behavior problems, please state that:
32. Describe the kind of temperament you are looking for in a dog (check all that apply):
Energetic
Couch potato
Watch dog
Affectionate
Independent
Gets along with other dogs
Gets along with cats
Does well with children
Loves all people
33. What gender do you prefer?
Male
Female
Either
34. Would you consider the opposite sex, if one is more readily available?
Yes
No
35/36. Explain why you would only want a female or why you would only want a male:
37. Would you consider adopting a special needs dog, such as one with physical or sensory impairments or who requires medication for a permanent but controlled condition?
Yes
No
38. Age preference (check all that apply):
8 weeks to 1 year
1 year to 2 years
2 years to 6 years
6 years or older
39. Some Airedales are accustomed to being allowed on furniture, others are not. For placement information purposes, will your dog be allowed on the bed or other furniture?
Yes
No
40. Have you ever had to give up a pet?
Yes
No
41. Have you ever had a pet run away, get lost, killed or stolen?
Yes
No
42. Have you ever had a pet euthanized?
Yes
No
43. Describe circumstances:
44. Who will be primarily responsible for the Airedale?
45. Daily work hours of primary caretaker:
46. How many hours will the dog be alone on the average day?
0-1 hours
1-2 hours
2-4 hours
4-6 hours
6-8 hours
47. Where will the dog stay during when no one is home?
48. Where will your dog sleep at night?
49. Will the dog have the run of the house when you are home?
Yes
No
Other
If Other, explain:
50. Are you familiar with crate training?
Yes
No
51. When would you use a crate?
52. Where would you put a crate?
53. Describe your plan to provide your dog with daily exercise:
54. What activities will you share with your dog?
Walking
Hiking
Obedience Classes
Agility
Playing Catch
Swimming
Other
55. Do you have any experience with obedience training?
Yes
No
56. Describe your dog training experience:
57. Housing Type:
Single Family Home
Apartment
Condo/Townhouse/Duplex/Triplex
Manufactured Home (multi-residence complex)
Guesthouse
Farm or Ranch
Other
58. Do you own or rent your primary residence:
Own
Rent
59. How long have you lived in this residence?
Less than one year
More than one year
60. Do you have plans to change your residence (moving or vacation) in the next 90 days?
Yes
No
61. Do you have a yard?
Yes
No
62. Is your yard fenced?
Yes
No
63. Type of fence:
Solid wall (example - wood, vinyl, aluminum, block)
See through fence (example - chain link, wrought iron
invisible electric fence
64. Is the fenced yard directly attached to the house?
Yes
No
65. What are the approximate dimensions of the fenced yard?
66. How tall is your fence?
67. Do you have a dog door already installed?
Yes
No
68. Do you have a place in the yard where the dog would be allowed to dig?
Yes
No
69. Do you have a pool?
Yes
No
70. If yes, is there a fence that would keep the dog out when no human is present?
Yes
No
71. Would you allow your dog in the pool if s/he liked to swim?
Yes
No
72. Do you have an additional residence?
Yes
No
If yes, is it a vacation home or summer/winter residence?
73. Location and Description of other residences, including whether there is a fenced yard
74. How often will you travel without your dog?
75. What arrangements will you make for your dog when you are traveling?
76. Name, Address and Telephone number of Veterinarian:
77. Which of your pets have seen this vet and when was the most recent visit?
78. Name, Address and Telephone number of Groomer:
79. The cost of owning a dog can be estimated at $700-3000 per year . Can you afford that expense?
Yes
No
80. I understand that rescues are spayed/neutered or have a spay/neuter contract.
Yes
No
81. I understand that if at any time an adopter cannot keep the animal, it must be returned to Airedale Rescue.
Yes
No
82. I understand that if an Airedale is placed with me, I will be asked for a donation of $500 or more
Yes
No
83. Would you be interested in volunteering by fostering, transporting etc. Please indicate how you would like to help.
Transporting
Fostering
Interviewing applicants
Mentoring new owners
Dog training
Organizing dog play dates
Correspondence
Website
Bookkeeping
84. What is your anticipated time frame for adopting a dog? (We will not hold you to your reply; it is just to assist us in the planning and matching process.)
Immediately
Near Future (1-3 months)
Within the year
Whenever the right dog is available
85. Is there any other information you would like us to consider?