Please fill out the following 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.
Should 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:
$425 -- 1 year and under
$400 -- 1 year and under 2 years
$375 -- 2 years and under 3 years
$350 -- 3 years and under 4 years
$325 -- 4 years and under 5 years
$300 -- 5 years and under 7 years
$275 -- 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
