Wetzel County Animal Shelter

Rescue Application

Please fill out the following application carefully and completely. The application is designed to help us make the best placement possible for our pets.

PLEASE READ THE FOLLOWING SECTION CAREFULLY. IN ORDER TO BE CONSIDERED YOU MUST:

· Be willing and able to provide medical care and loving attention.

· Be willing to have the pet examined by a veterinarian and provide any needed treatment at your own expense.

· Have the pet vaccinated against rabies.

· Have the pet spayed or neutered (if not already done).

· Abide by city, county, and state ordinances and laws.

· Make sure the dog wears a collar with a rabies tag and ID.

· Abide by all the rules of our adoption agreement.

· Understand that the Wetzel County Animal Shelter reserves the right to deny any application.

I have read, understand, and agree to the above adoption (rescue) requirements.

Signature_____________________________________Date________________

Animal(s) that you are interested in:___________________________________________

Name and Address of your Organization: ________________________________________

___________________________________________________________________________

Rescue Contact Phone #:________________________Email:________________________

Website? ______________________________________501(c)3?__________

Are you a Rescue or Sanctuary? _______ If you are affiliated with a National Rescue, please give name, address, and contact phone #: _______________________________

Do you have a shelter facility? _____ If so, address:____________________________

No. of yrs. in operation: __________ Approx. # of placements/yr.:_________

Do you do home checks prior to placement? ____

Do you require spay or neuter prior to placement? _____

***Are you willing (upon request) to provide us with name and contact information for foster and/or adopter of the animal(s) we send to you?_______

***Will you reimburse us for the vetting we have done prior to the dog coming to you?( ie..alteration/vaccinations/medical care from a veterinarian.)______________________

Will you send us paperwork after the pet is placed? _____

May we visit you in the future to verify the pet’s well being? _______

Do you have a transport system in our area? _____________________________________

Have you pulled from shelters in your area? _____ If so, give shelter names and phone numbers: ___________________________________________________________________

Please give name and phone numbers of veterinarians you use for rescues in your area:

Name _____________________________________ Phone # _____________________

Name _____________________________________ Phone # ______________________

I understand that Wetzel County will not reveal to any person other than an authorized county official any of our personal information or the fact that we have rescued any particular animal to a prior owner or custodian of that animal.

Signature _____________________________________ Date: ______________________

(Mail to: Dir., Wetzel Co. Animal Shelter, RR2 Box 57, New Martinsville, WV 26155)