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									Westie Rescue of Canada
   Dedicated to the protection and well -being of West Highland White Terriers




        APPLICATION TO ADOPT AND/OR FOSTER A WEST HIGHLAND WHITE TERRIER

Please print out, read and carefully complete this application to adopt and/or foster a Westie. Please do not complete
this document electronically or alter it in any way, and ensure you sign it before returning it to us by mail. We screen
all applicants very carefully for the good of the Westie and the adopting and/or foster family, so please be as thorough
and accurate as possible. Feel free to attach additional notes if you wish. All forms will be kept on file for one year.
After that, any applicants still considering adopting or fostering a Westie should re-apply with their current information.

Thank you for your cooperation.

Part I: Personal Information

Surname:                                                                     First Name & Initials:

Address:

City:                                                  Province:                               Postal Code:

Telephone: (Res)                                                           (Bus)

Number of adults in household:                                    Men:                         Women:

Children:                        Boys (ages):                                         Girls (ages):

Describe the type of dwelling you reside in:



Do you own or rent?

If you live in a condo, do the bylaws allow a dog?              [ ] Yes [ ] No

If you rent, have you obtained the landlord's written permission, either by way of lease or letter, to keep a dog?
[ ] Yes [ ] No

Have you had a Westie before?

Do you have any other breeds of dog? If so, which breeds?



Do you belong to any Dog Organizations or Clubs? Please list them:




                                                    Application to Adopt and/or Foster
                                                               Page 1 of 13
What type of rescue are you looking for?      Approx. Age:                                Sex:

Would you consider the opposite sex?          [ ] Yes [ ] No

Would you be interested in an older dog?      [ ] Yes [ ] No


Part II: Environmental Information

How large is your yard?

Is it securely fenced?      [ ] Yes [ ] No    (if "yes" what kind and how tall?)



If the yard is not securely fenced, what type of improvements need to be made so that it is secure?




Are you willing to make such improvements?              [ ] Yes [ ] No

What type of gates?

Are gates permanently locked?       [ ] Yes [ ] No

Can strangers gain access to your yard from the street?

If you have a pool describe pool fencing and gate:



If you have a dog run is it secure? Please describe:



Are you aware of any dangers that could harm your dog inside the yard?



If your yard is not fenced, how do you plan to insure that the dog receives safe and adequate exercise?




Where will the dog sleep?




                                             Application to Adopt and/or Foster
                                                        Page 2 of 13
Do you plan to keep the dog primarily indoors or out? Please elaborate.



Do you plan to use a crate? How, when, why or why not?




Part III: Pet History

Why do you want a Westie, as opposed to another pet?



Have you ever owned a Westie before?        [ ] Yes [ ] No      How long?

What happened to him/her?



Where did you get that Westie?

Who is this Westie for?

Do you have other pets at this time?        [ ] Yes [ ] No

What kind/age/ sex?



Where did you get your pets?



How long have you had them?



If you don't have a pet now, have you owned one before?         [ ] Yes [ ] No

What kind and sex?




                                           Application to Adopt and/or Foster
                                                      Page 3 of 13
How long did you have him/her?

What happened to him/her?



If you have had other animals what has been your main problem(s) with them?




Can you isolate the Westie from the other animals if they cannot get along?        [ ] Yes [ ] No

(Describe):




Part IV: Behavior

What type of behavior do you expect of this dog?

What amount of time and effort can you devote to training your Westie?



Are you planning to enroll this dog in obedience class?

Which family members will be assisting in home training?

What is your initial reaction to the idea of disciplining your dog?



What is your method of disciplining a dog?



Do you expect a rescue Westie to already be housebroken?

How will you deal with behavior problems in a rescue? (e.g. dog aggression, house soiling)




Part V: Family Information

Have you discussed with all members of your household the pros and cons of owning a Westie?




                                              Application to Adopt and/or Foster
                                                         Page 4 of 13
Does your lifestyle allow for enough time and energy to properly care for a dog?

Do you work outside the home?        [ ] Yes [ ] No

If yes, how many hours a day will the dog be left alone?

Is your lifestyle such that friends, relatives and children gain admittance to your home, property and car without your
supervision?        [ ] Yes [ ] No

If you have young children, are you willing to accept the additional responsibility of a Westie?

Does EVERYONE in your family want a dog?

What is your family’s overall reaction to owning a dog?

Which members are enthusiastic?                                             Unenthusiastic?

Is anyone in your household allergic to pets?

What, if any, concerns have been voiced by other family members?



Which other breeds have you been contemplating?



Westies can live upwards of 15 years. Are you and your family committed to caring for it that long?

If you are willing to provide a home for an older Westie, have you considered that its remaining years may be few, and
possibly sickly? (Please comment)



Is there anything else that you want to tell us about your family and your suitability to adopt a rescue Westie?




                                             Application to Adopt and/or Foster
                                                        Page 5 of 13
We will require a visit to your home. We also wish to meet ALL residents of your household. Do you anticipate any
problems with this?          [ ] Yes [ ] No

If answer is yes, please explain:

If you are interested in both fostering and adopting a Westie, please complete the following section. If you are
interested in adoption only, please skip this section and go directly to Part VII (page 11).


Part VI: This Section is to be Completed Only if You Are Interested in Fostering a Rescued Westie

Why are you interested in fostering a Westie?

How do you think your other pets (if you have any other pets) would react to a rescue dog?



Are you able to deal with reactions on the part of your pets?

Are you prepared to provide the extensive socialization that is needed to ensure that you have a well-rounded Westie
for eventual permanent placement?

Please check any area that you WILL NOT be able to expose a foster Westie to (UNDER YOUR SUPERVISION):
(Check all that apply)

[   ]   other dogs             [ ] other people          [   ]   small children         [ ] cats
[   ]   other pets             [ ] riding in a car       [   ]   housebreaking          [ ] crate training
[   ]   obedience training     [ ] leash training        [   ]   being alone in a fenced yard (while you are home)
[   ]   being alone in a room (while you are home)       [   ]   being alone in a car (while you observe)

Will you need someone to handle: Grooming                [ ] Yes [ ] No
                                 Nail Clipping           [ ] Yes [ ] No

What medical considerations will affect your ability/willingness to house a rescued Westie? (e.g. won't take a dog
diagnosed with heartworm, or a diabetic Westie?)




Are you agreeable to spaying/neutering EVERY dog that you foster (veterinary expenses will be paid by the rescue
organization) and are you able to care for a dog recovering from surgery?      [ ] Yes [ ] No

Why or why not?

How many dogs are you willing to foster at once:         [ ] One              [ ] Two           [ ] Three
[ ] Other

Are you likely to do any training with the foster dog while in foster care?

                                              Application to Adopt and/or Foster
                                                         Page 6 of 13
What type?

What is your method of disciplining a dog?



How will you deal with behavior problems in a rescue? (e.g. dog aggression, house soiling). Abused rescues can
require an endless amount of patience and attention, without harsh discipline. Are you sincerely able to provide this
type of care?




Tough Decisions

If it becomes necessary to euthanize a Westie that is in your care, or under your supervision in a foster home, would
you be able to handle the situation?        [ ] Yes [ ] No

Are you agreeable to having dogs euthanized because of irreversible temperament problems?           [ ] Yes [ ] No

Why or why not?




If you answered No, what would be your alternative solution?



Might you possibly be able to commit the next 12 – 15 years of your life to any dog you rescue, should a placement
not work out and the dog has to come back to rescue?

How would you handle a situation in which a rescue dog bit you?



Or someone else?



Do you have the support of your family in regards to fostering a rescue?

Are you willing to work closely with the Westie Rescue of Canada when your foster Westie is ready for an eventual
placement in a permanent home?                [ ] Yes [ ] No

Are you financially able to provide adequate food and routine medical care for the foster Westie?




                                             Application to Adopt and/or Foster
                                                        Page 7 of 13
Have you emotionally prepared yourself for the sadness that comes when Westie Rescue of Canada finally makes a
permanent placement?

Are you willing to stay in contact with the adoptive home to ensure that the placement was a success, including follow-
up visits and/or phone calls?         [ ] Yes [ ] No

Are you willing to provide counseling/resources to the adoptive family should problems arise later on in the
placement?         [ ] Yes [ ] No

Is there anything else that you want to tell us about your family and its suitability to foster a rescue Westie?




How did you find out about us?

Your comments or suggestions:




                                              Application to Adopt and/or Foster
                                                         Page 8 of 13
References

References will be verified. Please list three references that can attest to your suitability as a pet owner, and more
specifically, the owner of a rescued Westie. If you own, or previously owned any pets, you should include your
Veterinarian as an additional reference. Furthermore, if you are renting, then you will also need to provide a reference
from your landlord, along with a copy of your lease, or a statement from your landlord authorizing you to keep the dog.

Name:                                                              Telephone (Res):

Address:                                                           Telephone (Bus):

City:                                          Province:                              Postal Code:


Name:                                                              Telephone (Res):

Address:                                                           Telephone (Bus):

City:                                          Province:                              Postal Code:


Name:                                                              Telephone (Res):

Address:                                                           Telephone (Bus):

City:                                          Province:                              Postal Code:


Veterinarian:                                                      Telephone (Bus):

Landlord (if applicable):                                                    Telephone (Bus):


If you are interested solely in providing foster care to rescued Westies, please sign and date Section A. If you wish to
adopt a Westie in addition to providing foster care to rescued Westies, go to Section VII, Page 11.

The following is to be signed by foster home applicants ONLY:

I/We,                                                                                                                      ,

attest that, to the best of m y/our knowledge, the above information is accurate and complete at the time of signing,
and I/We understand that falsely provided information can mean that my/our application will be terminated.


Signature:                                                                          Date:

Signature:                                                                          Date:




                                             Application to Adopt and/or Foster
                                                        Page 9 of 13
Thank you for your cooperation. This comprehensive questionnaire helps us in placing the right dog with the right
foster and/or adoptive family. An improper placement or one in which all the details weren’t known, can end tragically,
usually for the Westie. Though it is hard to let go of a rescue Westie to a permanent home, there is possibly another
one waiting that could be just as needy, if not more so. Please be aware that foster help doesn’t just end with the
placement, nor does keeping the dog in your home constitute all of the needs of rescue. Every individual is suited to a
different aspect of rescue, and we will work with you to assign you in a capacity where you are comfortable and can
make a difference.

Please return this application by regular, postal mail to the Westie Rescue of Canada representative whose contact
information you received by emailing adopt-foster@westierescuecanada.com




                                            Application to Adopt and/or Foster
                                                       Page 10 of 13
Part VII: For Applicants Interested Solely in Adopting a Rescued Westie

How did you find out about us?

Your comments or suggestions:




REFERENCES

References will be verified. Please list three references that can attest to your suitability as a pet owner, and more
specifically, the owner of a rescued Westie. If you own, or previously owned any pets, you should include your
Veterinarian as an additional reference. Furthermore, if you are renting, then you will also need to provide a reference
from your landlord, along with a copy of your lease, or a statement from your landlord authorizing you to keep the dog

Name:                                                             Telephone (Res):

Address:                                                          Telephone (Bus):

City:                                          Province:                             Postal Code:


Name:                                                             Telephone (Res):

Address:                                                          Telephone (Bus):

City:                                          Province:                             Postal Code:


Name:                                                             Telephone (Res):

Address:                                                          Telephone (Bus):

City:                                          Province:                             Postal Code:


Veterinarian:                                                     Telephone (Bus):

Landlord (if applicable):                                                   Telephone (Bus):




                                            Application to Adopt and/or Foster
                                                       Page 11 of 13
I/We,                                                                                                                    ,

attest that, to the best of m y/our knowledge, the above information is accurate and complete at the time of signing,
and I/We understand that falsely provided information can mean that my/our application will be terminated.

I/We understand and agree to make a minimum donation of Two Hundred and Twenty Five dollars ($225.00), and that
the donation is not a fee or sale price, but a non-refundable donation once the adoption is final, which goes directly
toward helping to offset all medical costs associated with Westie Rescue of Canada's services.

Signature:                                                                         Date:

Signature:                                                                         Date:


Thank you for your cooperation. This comprehensive questionnaire helps us in placing the right dog with the right
family. An improper placement, or one in which all the details weren’t known, can end tragically, usually for the dog.
Please return this application by regular, postal mail to the Westie Rescue of Canada representative whose contact
information you received by emailing adopt-foster@westierescuecanada.com




                                             Application to Adopt and/or Foster
                                                        Page 12 of 13
Part VIII: Verification of References & Home Visit: (Please do not complete this section. It will be completed by a
representative of Westie Rescue of Canada).

Reference 1:                                                              Date:

Verified by:

Comments:



Reference 2:                                                              Date:

Verified by:

Comments:



Reference 3:                                                              Date:

Verified by:

Comments:




Landlord:                                                                 Date:

Verified by:

Comments:




Veterinarian:                                                             Date:

Verified by:

Comments:




House Visit by:                                                           Date:

Comments:




                                           Application to Adopt and/or Foster
                                                      Page 13 of 13

								
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