Adoption Application "*" indicates required fields Contact Information and Desired Dog(s)Name* First Last Phone*Email* Enter Email Confirm Email Address* Street Address Apt, Unit # (if applicable) City State Enter your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Name of Dog You Wish to Adopt*List the dog that is your first choice to adopt. Are There Any Dogs You Would Consider as Alternates?If you would like to list additional dogs as alternates if your first choice is not a good fit or is not available, please list them below. Click the (+) sign to add a new line if you would like to add more than one alternate dog. Add RemoveDetails About the HomeDo you own or rent your home?* Own Rent Do you have a yard?* Yes No Is your yard fenced?* Yes No Describe your fencing*Do you have a pool?* Yes No Does your pool have safety fencing around it?* Yes No Are there children in the home?* Yes No List the children's ages*If you have more than one child in the home, click the (+) button to add another line Add RemoveRate the activity level of your householdThis helps us to ensure the dog’s energy level is a good match for your household. High – Like to jog, go for long walks, etc. Moderate – Like to go for regular walks, have a big backyard, etc. Low – Like to go for occassional walks, relax at home, etc. Pet Ownership DetailsHave you owned a dog before?* Yes No Do you own any other pets?* Yes No If you have other dogs, are they spayed/neutered?* Yes No I don’t have other dogs List Current Pets*Please list the pets you have in the home. If you have more than 1, click (+) to add additional lines.Pet NameBreedBehavior Towards Other Dogs Add RemoveHave you ever surrendered a pet before?* Yes No Describe the circumstances of the surrender*How many hours per day would the dog be alone?*Will you crate the dog?* Yes No Where will the dog sleep?* Indoors Outdoors Other If you leave town, where will the dog stay?*How would you deal with behavior issues with your dog?*Have you ever been convicted of an animal-related crime?*Examples – animal cruelty, animal theft, animal abandonment Yes No Anything else you would like us to know about you?How did you hear about us? Petfinder Adopt-A-Pet Nextdoor Facebook Instagram Wilton Animal Rescue website Internet Search A friend referred me Other Recommendations and AcknowledgementsYour Veterinarian's Name* First Last Your Veterinarians's Phone*By clicking submit, I understand the following:Consent*I verify that all of the above information is true and accurate. Verified*Consent*I authorize Wilton Animal Rescue to conduct a home check, including a check of the yard fencing. This is a requirement for all WAR adoptable pets. Authorized*Consent*I understand that Wilton Animal Rescue will disclose any of the dog’s health or behavioral issues known by the above-named rescue group before an adoption is completed. Understood*Consent*I understand that if I no longer want or am unable to care for my adopted dog, I will surrender my dog back to Wilton Animal Rescue Inc and provide transport back to Wilton Animal Rescue. Understood*Consent*I agree to indemnify and hold harmless Wilton Animal Rescue Inc. against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed. Agreed*Consent*I agree to pay the adoption fee listed in Petfinder for the dog(s) I am interested in. The fee allows us to provide spay/neuter, vaccinations and microchip as well as any other vet care needed for the dog. Payment can be made via Venmo, Zelle, PayPal, Money Order or Cash Agreed*Consent*I acknowledge that should I proceed with adopting a dog from Wilton Animal Rescue, I have the option of keeping the adoption private. If I opt for a private adoption, WAR not post information or pictures on social media and will not send me requests for post-adoption updates. Agreed* Δ
