Winston’s Wishes Adoption Application

Please fill out the form below and one of our adoption coordinators will be in contact with you!

* Please note - Applications will not be considered if information is missing and are not first come, first serve

to ensure we are available for guidance and support after adoption day, we have an adoption radius of 1.5 hours outside of the janesville, wi area

Name

First Name

Last Name

Best Contact Number

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Facebook Handle/Link

Instagram Handle/Link

Name of dog you are interested in adopting

Please tell us what lead you to apply for the pup you are interested in, how did you see or hear about them?

This helps us with making sure we are promoting our adoptables the best way we can 😊

Names & ages of additional household residents

Do you currently:

How long have you lived at current address?

If you rent, what is the name & phone number of the Landlord/Managment Company?

Employment Status

Any additional info you'd like to share about Employment Status

Have you ever adopted a pet from another rescue and/or shelter?

If yes, which rescue/shelter?

Are there any other pets in the household?

If yes, please list Name, Sex, Type/Breed, Age, & Veterinarian for each.

Are your pets spayed/neutered?

If your pets are not spayed/neutered, what is the reason they are not?

If you've had dogs in the past, we would love to learn more about them if you'd like to share below!

Do you use shock, choke, and/or prong collars?

If yes, please explain further:

What methods to you use to train a dog to learn positive behaviors & manners?

Do you have a fenced in yard?

If not, how will you be sure your pup does not wander?

Approximately how many hours would the pup be alone each day ? Please explain:

Where will your dog be kept during the day? Night?

How would you exercise and provide mental enrichment for the dog?

Have you ever surrendered, or rehomed, a pet?

If yes, please explain:

Please list two personal references who do not live in the same household. Include their name, how you know them, and their phone number.

Is your home within a 1.5 hour radius of Janesville, WI?

PLEASE KEEP IN MIND, WITH US REGULARLY CHECKING IN WITH OUR ALUMNI AND WITH US ALWAYS BEING THERE FOR SUPPORT & RESOURCES, OUR PUPS ARE ADOPTED OUT TO FAMILIES WITHIN A 1.5 HOUR RADIUS OF JANESVILLE, WI AREA.

Would you be interested in becoming a Winston's Wishes Event Volunteer?

If yes, we will add your email to our list and our Volunteer Coordinator will be in touch!

Absolutely!

Not at this time.

Is there any other information you would like to share with Winston's Wishes?

By digitally signing below, I certify that the information I have given above is true and correct. I recognize that any misrepresentation of facts may result in my privilege of adopting a pet from Winston's Wishes being revoked. I understand that Winston's Wishes has the right to deny my request to adopt a pet. I authorize investigation of all statements in this application, including veterinarian records, landlord/management companies, inquiring with mutual persons, and other humane societies/rescues. I understand that the information provided above could be made available to other rescues/humane societies. I agree to release Winston's Wishes from any liability for damage or injury caused by animals in their care during and after the adoption process. This form will become the property of Winston's Wishes. Winston's Wishes reserves the right to refuse any adoption for any reason. Lastly, I understand that Winston's Wishes adoption process is not a first come, first served process. Winston's Wishes thoroughly reveiws applications and places animals into homes that best fit everyone involved. Please type your name below if you agree with the above paragraph.