Adoption Application

Please fill out the form and click send on the bottom of the page to submit.

Last Name First Name

Address

City State Zip

eMail Home Phone Work Phone Cell Phone

Why do you want to adopt a Soft Coated Wheaten Terrier?

Have you previously owned a Wheaten? What other breed(s) of dog have you owned?

What happened to your last dog?

Do you have other dogs or cats?

If yes, specify breed, sex and age of all dogs and cats in the home

Are other dogs in the home spayed/neutered?Yes No

How many adults in the household?   How many children?

Please state ages of children 

Are all family members "on board" with getting a Wheaten?

Who will be the primary care giver for the Wheaten?

Is someone home during the day?

What is the longest time the dog would be left alone?

Where will the dog spend the day or be kept when you are gone from home?  (Loose indoors, loose outdoors, crated, kennel run, tied out, other-specify)

Do you have a fenced yard?

What kind of fence?

Do you own your home or lease?

If you rent, do you have your landlord's permission to have a dog?

Do you intend to keep your Wheaten outdoors or indoors?

Are you aware of the grooming needs of a Wheaten?

Will you obedience train the dog?

Are you willing to adopt a dog that needs additional training?

Will you accept a dog needing special medical attention?

Since Wheatens normally remain spirited and active well into the double digits of their lives, are you willing to adopt an older dog?

Do you have a preference as to Male or Female?

Do you have a current veterinarian?

Veterinarian Name

Address City State Zip

Telephone number

How far or to what other states, would you be willing to travel to obtain a Wheaten?

How did you learn about Wheatens In Need? 

Additional information you would like to give us..

Without the help of hard working volunteers, WIN would not be able to rescue and rehome Wheatens.  There are many ways to help.  We need experienced, (dog knowledgeable) people to foster, we also need volunteers to help WURL (transport our dogs), and of course we need financial support.  Take a look at our Volunteer Information and let us know if, after you have gotten your Wheaten, you would be willing to become a WIN volunteer.

I hereby certify that all the information contained on this application is true and correct. I certify that my purpose in adopting a Soft Coated Wheaten Terrier is to have a family pet and not to use for research. I understand that I will be required to sign a Conditions of Adoption Agreement and a Placement Agreement. This application will become part of those agreements, and any misrepresentation in this agreement will constitute a breach of the Conditions of Adoption and the Placement Agreement.

Our Adoption Applications are filed by State.  Please mention your State when inquiring about your application.  Shoudl you get another dog and are no longer interested in adopting from WIN, please let us know so we can delete your application from our files.

The adoption fees are as follows:

$400 -- 1 year and under
$375 -- 1 year and under 2 years
$350 -- 2 years and under 3 years
$325 -- 3 years and under 4 years
$300 -- 4 years and under 5 years
$275 -- 5 years and under 7 years
$250 -- 7 years and older

The adoption fee is due on receipt of the Placement Agreement and the Conditions of Adoption

Wheatens In Need is a 501c-3 non-profit organization and is funded entirely though private donations and adoption fees.

By signing this application, I agree to pay the adoption fee appropriate for the Wheaten that I adopt.

Signature