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Weimaraner Association of Canada - Rescue Adoption Application
Revised 05/2001
Thank you for your interest in adopting a Weimaraner.
This questionnaire is designed to help us match available Weimaraners with the most suitable home and family.
The ONLINE APPLICATION can either be printed and snail mailed (see address at the
bottom) OR
copied** into your email program.
**To copy the questions all you need to do is: select the text with your mouse -
(highlight the area you need to copy by clicking your left button and holding it down until
you've selected the whole area you need), then press the "ctrl+ c" keys or "copy" and
"ctrl+ v" or paste to insert it into your word processor or email document.
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IDENTIFICATION
Name: _________________________________________________________________________
Address: _______________________________________________________________________
Phone (Home)__________________________________ (Work) __________________________
e-mail: ________________________________________
1. Please list the names & relations of all family members and others living in your home.
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2. If there are children, what are their ages?
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If no children - are you planning on having children in the future?
_____________When?_________
3. Does anyone in your family suffer from allergies? yes / no
(if yes - what are they and how bad are they?)
_______________________________________________________________________________
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4. Please list the occupations of adult family members.
_______________________________________________________________________________
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GENERAL
5. Why are you interested in getting a dog at this time?
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Is there a particular reason your are interested in a rescue?
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What has attracted you to the Weimaraner breed?
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6. Are there any special activities you would like to do with your dog?
Obedience competition_________ Hunting _______ Agility ________ Flyball__________
Other:
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7a. Do you prefer: Male__________ Female ______________No preference_________________
If male or female, is there a special reason for your preference?
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b. Do you have any age preference ( puppy 1-6 mos; teen 9-24 months; adult 3-6 ; veteran 7+)?
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c. Would you be willing to adopt an older adult (3-6 yrs)? A veteran (7+ yrs)?
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EXPERIENCE
8. Is this your first dog? yes / no ______________
If NO, please list the dogs you previously owned; their breed, when you owned them, and what became of them.
_______________________________________________________________________________
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9. Do you have a dog now? yes / no
If YES, please indicate: Breed(s), age(s) & sex(es).
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How long have you had your dog(s)?
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Where did you get your dog(s)?
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Are they Spayed or neutered? _________________________
10. Do you have any other experience with dogs? Please specify.
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11. Do you own any other animals at present (cats, birds, other)? ______
Please specify:
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LIFESTYLE/OWNERSHIP
12a. Will your dog routinely be left alone during the day, and if so, for how long?
_______________________________________________________________________________
b. Where will the dog be when left alone?
_______________________________________________________________________________
c. What provisions, if any, will be made if the dog must be left for extended periods of time?
_______________________________________________________________________________
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13. How has the family prepared for taking in a new dog?
_______________________________________________________________________________
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Are all adult family members prepared to take responsibility for the care and exercise of this dog?
_______________________________________________________________________________
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What are your expectations of this dog?
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14. How will you meet your dog's exercise needs?
_______________________________________________________________________________
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15. Do any family members travel a lot (work, business or pleasure)?___________
What will you do with the dog when you are away on vacation?
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16a. Do you
have any special experience training dogs &/or correcting specific problem
behaviours, including with your own dog(s)? (Yes/No) _____
If YES, please explain (What was the problem & how did you correct
it).
_______________________________________________________________________________
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b. Are you willing to consider adopting a dog with behaviour problems such
Separation Anxiety or a history of aggressive or destructive behaviour?
_______________________________________________________________________________
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c. Are you willing to consider adopting a dog with known chronic medical
problems?
Are you prepared to cope with the
additional demands and somewhat higher than average veterinary expenses?
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17. Are you planning to crate train your dog? _______________
18. Do you plan to take the dog to basic obedience classes? __________
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PHYSICAL LAYOUT OF HOME
19a. Do you: Own or Rent?
b. Type of Dwelling: House Condo Townhouse Apartment Other (please specify)
20. Is your area: Urban?_______ Suburban? ________Rural?______
21. How large is your yard? ____________________________________
22. Do you have a fenced yard or area? Yes / No __________
If yes: How high is the fence?
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What type of fence is it? (chain link, picket, wood, invisible)
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Is it escape proof? yes / no_____________
If not: What precautions will be taken to keep dog from wandering?
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23. How did you find out about us?
_______________________________________________________________________________
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24. Who is or who will be your Veterinarian?
(Please provide the Vet's Name, Clinic Name, Phone number)
_______________________________________________________________________________
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25. Are you or have you been a member of a breed or all breed club?
If yes, which club?
_______________________________________________________________________________
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26. Any additional information you would like to share with us?
(Please share your thoughts, your worries, your questions)
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Happily, we have experienced a recent decline in the number of dogs needing to be placed in new homes.
The Weimaraner Association of Canada Rescue has entered into an agreement with the Weimaraner Club of
America Rescue that will allow the placement of dogs in the US rescue program to be adopted by Canadian homes.
27a.Do we have your permission to release the above information to other Weimaraner Rescue groups? (Yes/No)
_______________________________________________________________________________
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b. Would you be willing to travel to the US to pick up a rescue there? (Yes/No)
_______________________________________________________________________________
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c. How far are you willing to travel?
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Please return completed form to the Weimaraner Association of Canada eFax at 1-208-379-3517 *** If you do not hear from us within a reasonable time limit |
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You may also want to submit to your Local Rescue Representative. Contact Information listed on the website at: www.weimaranercanada.org/rescue |
W.A.C.
club at weimaranercanada.org