Airedale Rescue & Adoption

Application for Adoption


Referred By_________________

We ask that all members of the family be involved in answering the questions in this application, but that the form itself be filled out by the wife.

Name_________________________________ Phone _____-______-________





Work phone _____-_____-________


House: Own___ Rent___ Apartment/Condo: ___ Urban___ Suburban___ Rural___

Please list all family members and their ages. (Please include live-in help and frequent visitors.)

_________________________ ____ _________________________ ____

_________________________ ____ _________________________ ____

_________________________ ____ _________________________ ____

_________________________ ____ _________________________ ____

Are you SURE everyone in the family wants an Airedale? Y / N

Preferences: Male____ Female____ Size: Under or Over 60 pounds__________

Do you have a Fenced-in Yard? ____Yes ______ No

_____ Directly accessible from at least one door of the house.

_____ Detached from the house so that you must walk out to it.

Approx. Area______________________________

Type Fence _______________________________


How and how often would you handle exercise and “relief”(potty) periods:

Swimming Pool: Y / N

    In-ground____ Separately fenced? Y / N

    Above ground____"Dog-proof" steps? Y / N


Have you ever owned an Airedale? _____M____F____

What other breeds have you owned? ____________________

Do you have any house cats? (Please include number and their ages.)


Outside cats? Y / N

Please list all of your other pets, their ages, and indicate whether or not they are neutered/spayed:



What happened to your last dog? ______________________________________

How long ago? ____________________

Have you ever lost a dog other than through death?________

If so, how?_______________________________________

If you had to move, would you consider giving up your dog?_______

Has your ownership of a dog ever caused you to be in a court situation?_______

If yes, please explain:_____________________________________________________



Are you ready for a dog now?_______________

If not, what date did you have in mind?__________

Living With Your Dog:

Will your dog . . .

    Have the run of the house? __________

    If not, to what areas will he be confined? ________________________

    Be allowed on the furniture? __________

    Have dog beds or blankets here & there? _________

    Sleep in your bedroom? ___________

    If not, where? ______________________________

How many hours at a time is no one home?__________

Where will he be during this time? _________________

Are you familiar with a dog crate? Y / N

When would you use one? __________________________

In what room would you put the crate? ______________

Do you have dog beds or blankets here & there? _____

When you travel, where will your dog stay? __________


Your Veterinarian ______________________________________

Phone ______-_____-________

Address _______________________________________________________________

Personal References: (Please provide two, perhaps a friend and a neighbor)

Name _________________________________Phone ______-______-____________

Address _______________________________________________________________

Name _________________________________ Phone ______-______-____________

Address _______________________________________________________________

Comments or Special Stories:







Thank you for your application. We try to acknowledge each application when received, but if you don’t hear from us for awhile, feel free to contact us. Even if your application is acceptable, we may not immediately have the right dog for you. House checks are routine, but many times we wait until we feel we have the appropriate dog for you.

Please make sure you are willing to comply with the conditions detailed in the placement agreement before sending in this application.

Please return the completed application to:

There is an adoption fee:
    Up to age two: $300
    Two to four years: $250
    Four to six years: $200
    Six to eight years: $150
    Over eight: $100

We do reserve the right to refuse an applicant.

Donate with PayPal or Credit Card


Click here for other ways to donate

Airedale Information

The ATCA Rescue & Adoption Committee maintains and updates a network of contacts across the country to aid in the re-homing of purebred Airedale Terriers who are lost or abandoned. These contacts are volunteers located in several states, as well as Canada, working to help Airedales in need, adopting them to permanent loving homes.
Go to Top
JSN Epic 2 is designed by | powered by JSN Sun Framework