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Adoption Applications

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Applicant Name*
FirstLast
Co-Applicant Name
FirstLast
Email Address*
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Are you willing to have a member of Rescue visit your home by appointment both before and after adoption?*
- Yes

Type of Residence*
- House
- Condo
- Apartment
- Ranch or Farm
Do you Own or Rent?*
- Own
- Rent
Do you have written permission from your landlord?
- Yes
- No
Landlord Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Landlord Phone

Family Information*
Please list family members who live with you along with their ages.
Visitors*
Please list family members and friends who visit regularly, but do not live with you, along with their ages.
Do you plan to add to your family in the next five years?*
- Yes
- No
Why do you want an Airedale Terrier?*
Do all family members want an Airedale Terrier?*
- Yes
- No
Explain*
If No, Explain who does not and why.

Describe your family's typical day and how your dog(s) fit into that day.
(or how you anticipate your new dog fitting in if you don't currently have a dog).
Is this your first Airedale?*
- Yes
- No
What do you know about about Airedales? Include titles of books read and describe other sources of information.
Aware of grooming needs?*
- Yes
- No
Anyone allergic to dogs?*
- Yes
- No

How do you feel about muddy footprints on carpet & bedspreads?*
Describe the kind of temperament you are looking for in a dog.*
(i.e., calm, energetic, aloof, affectionate, etc.)
What qualities appeal to you about the Airedale?*
Who will be the primary person responsible for the Airedale Terrier?*
Daily work hours of primary caretaker.*
Do you have any experience with obedience training?*
- Yes
- No
If so, please specify:*

Do you prefer:*
- Male
- Female
- No Preference
Would you consider the opposite sex if one is more readily available?
- Yes
- No
What will your Airedale need to get along with? (Check as many as are applicable)
- Dogs
- Cats
- Indoor Birds
- Small Rodents
- Poultry
- Livestock
- Children
- Women
- Men
- Other
Describe

How many hours will the dog be alone on an average day? (number 0-24)*
Please enter a value between 0 and 24.
Where will the dog stay during the day when alone?*
- N/A
- Loose in the house
- Crated in the house
- Loose in the yard
- In an outdoor kennel run
Where will the dog stay at night?*
Do you have a yard?*
- Yes
- No
Is your yard fenced?*
- Yes
- No
What are the approximate dimensions of your yard?*
Do you have an area in your yard the dog can use as a "digging pit?"*
- Yes
- No
Is the fenced yard directly attached to the house?*
- Yes
- No
How tall is your fence?*

List all animals currently in your household :*
(type, age, sex, neutered/spayed)
Do any of your current animals have medical conditions?*
- Yes
- No
Describe
Are your current dogs up to date on all shots?*
- Yes
- No
What brand of heartworm preventative are you presently using?*

You would consider giving up your dog if*
Have you ever given up a dog?*
- Yes
- No
explain
If you were unable to care for your pets (death, immobilizing disability), what arrangements have you made?*
How many dogs do you currently have*
- 0
- 1
- 2
- 3
- 4+
Has your dog ever lived with another large dog?
- Yes
- No
how long has your current dog been the only dog of the house?*

When will you be ready for your new dog?*
Dog Groomer (Business name/phone number)*
List name, address, telephone of your veterinarian*
Reference*
PLEASE LIST ONE REFERENCE NOT RELATED TO YOU (Name, Address, Telephone) If possible, list a neighbor and someone else familiar with your current or past pets
Any other information you wish us to consider in placing one of our Airedales with you?

Have you contacted a Rescue Volunteer in your area?*
- Yes
- No
Were there any Airedales available for adoption through your local Rescue?*
- Yes
- No
Name of Regional Club Rescue or Individual Rescue Volunteer you contacted
Have you ever adopted a dog through Airedale Rescue before? *
- Yes
- No
Name of Regional Club Rescue or Individual Rescue Volunteer who provided your previous Airedale.
Why do you want an Airedale from RESCUE?*
Do you understand that rescues are spayed/neutered or have a spay/neuter contract? *
- Yes
Do you understand that if at any time an adopter cannot keep the animal, it must be returned to Airedale Rescue?*
- Yes
Are you aware that if Rescue places a dog with you, you will be asked to make a donation, which helps defray costs such as shelter fees, veterinary care, etc.?*
- Yes
Name
This field is for validation purposes and should be left unchanged.

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