Wee Beasties On-Line Rescue Application Form

Application may be submitted in two different ways:

1. Complete this on-line form and hit the "SUBMIT" button when done

2. Print and complete the application and send by mail to:
Martha Straw
81 Anchorage Drive
Newport News, VA 23602



We try our best to respond to your application in a timely manner.
If you do not receive an acknowledgement within one week please contact:

Marty strawmc@cox.net
Kelly k527@hotmail.com



*** ALL FIELDS MUST BE FILLED OUT ***

 


Subject: 


Name of Applicant: Age: Name of Co-Applicant: Age: E-mail Addr: Street: City: State: Zip: Home Phone: Mailing Address: (if different) Applicant's Employer: Position Held: Phone: Co-Applicant's Employer: Position Held: Phone: Veterinarian: Address: Phone: Are you interested in adopting: Male Female Either Age you are interested in: Two Dogs Mixes Special Needs Elderly(8 and Older) Age you are interested in: Less than 18 months 18 months to 6 years Older than 6 years Any Age Reason?: 1. Explain why you want to adopt a Scottie (companion, guard dog, gift, etc.): 2. Do you live in a: House Apartment Duplex Condominium Townhouse Farm 2a. Do you Rent or Own? Rent Own 3. Do you have a fenced yard? Yes No If your answer is "Yes", what type of fence? Wood Chain Link Electric If your answer is "No", how will you excercise your Scottie? Who will supervise your Scotties outdoor activities? Do you have a pool? Yes No Do you live near a river or pond?Yes No 4. Where will this dog stay during the day? 5. Where will this dog be kept at night? 6. How many Adults/Ages live in your home? 7. How many Children/Ages live in your home? 8. Is anyone home during the day? Who?: 9. Who will be responsible for taking care of the Scottie/Age?: 10. How many hours will the dog be alone per day? 11. Who will care for your Scottie while you are on vacation? 12. If you move, what will you do with this Scottie?: 13. Are you willing to take responsibility for this Scottie for the next ten years or more? Yes No 14. How much do you think it will cost to take care for this Scottie each year(please consider cost of vet care, food, grooming, license, etc.)?: 15. Pets you currently own: 16. Other pets you have owned: 17. How did you hear about Wee Beasties Scottie Rescue? 18. References (please list two)

I ACKNOWLEDGE THAT ALL THE INFORMATION CONTAINED ON THIS APPLICATION FORM IS TRUE AND CORRECT. I UNDERSTAND THAT ANY MISREPRESENTATION MAY RESULT IN THE REMOVAL OF THE ADOPTED SCOTTIE FROM MY HOME BY THE WEE BEASTIES SCOTTIE RESCUE.

Form may be submitted on-line by clicking on the "SUBMIT" button below
or you can print and complete the application and send by mail to:
Martha Straw
81 Anchorage Drive
Newport News, VA. 23602

    



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Website Updated 3/22/2016 by PAW