WISH BONE CANINE RESCUE ADOPTION APPLICATION

Normal, Illinois

We accept applications from individuals 21 years or older.

You can expect to receive an initial contact email message from us within 48 hours .

Today's Date * +

Which dog would you like to adopt? *

If the above dog is no longer available and there are other dogs you are interested in, please enter name (s) below.

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Alternate Phone Number, if any

Email Address *

I have submitted an application within the past 6 months to adopt from Wish Bone Canine Rescue. *

No

Yes

I was notified my previous application was approved. *

No

Yes (enter month/year of approval) Yes (enter month/year of approval)

Have you acquired any dogs or cats since your previous application was approved? *

No

Yes

Describe the new pets you have acquired. *

Please enter your veterinarian's name and phone number. *

Have you ever been investigated for, charged with or convicted of animal negligence, abuse or cruelty? *

No

Yes

Please explain. *

Do you own or rent your place of residence?

*

I own my place of residence

I rent my place of residence

I live with a parent, friend or other relative

Type of residence *

Before you submit this application, verify with your landlord, homeowners association or management that you are permitted to have a dog. Check breed and size restrictions. Thank you!

Enter name of your trailer court *

Please provide your landlord's name. *

Please provide your landlord's phone number. *

Please provide your parent, friend or other relative's name. *

Please provide your parent, friend or other relative's phone number. *

Are you a student? *

No

Yes

Which address did you enter on this application? *

My hometown address

My student address

Student address is same as hometown address

Please enter your student address below. *

Please enter your landlord's name. *

Please enter your landlord's phone number *

Is there a cat in your family? *

No

yes

Do you currently own any dogs? *

No

Yes

What person's name are your pets under at veterinarian? *

Are there dogs living in your home that do not belong to you? *

No

Yes

Describe dogs living in your home that do not belong to you. *

Current Veterinarian's name

*

Current Veterinarian's phone number *

Which vet do you plan to use for your new pet?
(Please include vet's name and phone number) *

Please list your current dogs' names and describe them. *

0/2000 words

Are all your dogs' vaccinations up to date, including rabies and any additional vaccinations your veterinarian has recommended. *

No

Yes

Explain why your pet is not up to date on vaccinations. *

Are your pets spayed/neutered? *

No

Yes

Explain why your pets have not been spayed/neutered. *

Are your pets on flea/tick prevention? *

No

Yes (enter name of product) Yes (enter name of product)

Explain why your pet is not on flea/tick preventative. *

Are your dogs on heartworm prevention year round? *

No

Yes (enter name of product) Yes (enter name of product)

Please explain why your dog is not on heartworm prevention year round. *

0/1000 characters

Have you had dogs in the past? *

No

Yes

Please tell us about your previous dogs: names, breed and what happened to them. *

0/10000 words

For dogs described above, how long ago was it that you owned these dogs? *

Within the past year

More than 1 year ago

Please enter the vet's name and phone number for the pets described above that you no longer have. *

What person's name were your pets under at veterinarian? *

Will your new pet live inside your home?

*

No

Yes

Please explain where your new pet will live and why it is not living inside your home. *

Is there a child that lives in your home? *

No

Yes

What are their ages? *

Is there a child that visits your home? *

No

Yes

What are their ages and how frequently do they visit? *

Do you have a fenced yard? *

No

Yes

Enter height of fence. *

Energy levels and exercise needs are important in matching dogs with families. Please indicate which of the following fit your family's life-style. The dog we adopt needs to: *

be a couch potato

just run around/play inside house for exercise

just play/run in the yard alone for exercise

play with other dog in house or yard

take short daily walks

take long daily walks

be very active... such as jogging, playing frisbee or fly ball

Please describe how you intend to socialize your pet. *

0/2000 words

How many hours a day would your new pet typically be left alone? *

0/2000 words

Do you understand that adopting a pet is a commitment for the pet's entire lifetime?
Are you willing to make this type of commitment? *

No

Yes

Do all persons living in your home agree with adopting a dog at this time? *

Yes

No

Please explain who does not want to adopt a dog at this time and why. *

0/255 characters

Reference (needs to be an individual not living in your home)
First and last name *

Personal reference
Telephone number *

Personal reference #2 (needs to be an individual not living in your home)
First and last name *

Personal reference #2
Telephone number *

Please check box below if you would also like to become a foster home for Wish Bone. This application will serve as your foster application and a member of our foster team will contact you. However, please note that you must live within approximately 60 miles of Bloomington/Normal to become a foster.

No

Yes, sign me up!

Please enter any additional comments.

0/1000 characters

May we add you to our email list for distribution of our newsletter and other newsflashes about Wish Bone Rescue? We do not share our email list with others. *

No

Yes

Terms of Adoption

By checking the box below you are
(1) certifying that all information in this application is accurate and that you have not withheld pertinent information.
(2) authorizing Wish Bone Canine Rescue to contact your personal veterinarian to verify information you have submitted in this application as well as to verify in the future that the adopted dog is receiving care as recommended by your personal veterinarian.
(3) certifying that you are 21 years of age or older.
(4)acknowledging you understand that Wish Bone Canine Rescue reserves the right to deny any application for any reason without stated cause.

After checking the box below, remember to click the submit button to finalize your application. Thanks again for your interest in adopting one of our rescued animals.

*

I have read and agree with the terms in the above referenced documents.

Single family home	Duplex/Triplex/Quad
Condominium	Apartment
Trailer Court	Other Other