SCWTCSC Rescue Application

Rescue Application PDF for mailing only.

Date *

First Name *

Last Name *

Address *

City, State & Zip *

Home Number

Work Number

Cell Number

Email Address *

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

Have you previously owned a Wheaten? *

What other breed(s)of dogs have you owned? *

What happened to your last dog? *

Do you have other pets? *

If yes, specify type and sex of all dogs and other pets in the home.

Do you have children? *

If yes, please state their ages:

Is someone home during the day? *

If not home during the day, what is the longest time away?

Do you have a fenced yard? *

If yes, how tall is the fence?

Do you own, rent, or lease your home? *

Do you intend to keep your wheaten inside or outside? *

Are you aware of Wheaten Grooming needs? *

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? *

Are you willing to adopt an older/senior dog? *

Do you have a preference as to male or female? *

Do you currently have a family veterinarian? *

If yes, please state Vet name and telephone number:

How far into what other states would you be willing to travel to obtain a Wheaten? *

Additional information you would like to give us:

I hereby certify that all the information contained on this Rescue 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 an Adoption Contract and Ownership Agreement and a Release of Liability and Indemnification. This application will become part of those agreements by reference, and any misrepresentation in this application will constitute a breach of the Adoption Contract and Ownership Agreement. *

I agree

SCWTRSC Rescue Administrator Debbie Bowen at dbowen51@yahoo.com

The adoption fee is $500 plus applicable expenses ( i.e., Crate, vet bills, shots, etc) for dogs five years of age or younger and $350 plus expenses for dogs older than five years. Adoption fee is due at the time of adoption along with the Adoption Contract and Ownership Agreement.

The Soft Coated Wheaten Terrier Rescue of Southern California (A 501c3 Corporation) is funded entirely through private donations and adoption fees.

*If you receive an error with submitting, please click on the SUBMIT BUTTON again.*

Thank you for your message. It has been sent.

There was an error trying to send your message. Please try again later.

SCWTCSC Rescue Application

Title