WILD Canine Rescue
Mailing Address:
3309 Robbins Rd #109,
Springfield, IL 62704
Telephone: (217) 652-5505
Email: wildcaninerescue@gmail.com
www.wildcaninerescue.org

Application for Assistance for Home to Home Program
Our Home to Home Program works with families and individuals in crisis to keep their pets.  We help victims of domestic violence , hospitalized patients without options, and other emergency situations with foster homes, temporary boarding, and other assistance.  

Our Home to Home Program will help owners rehome their pet. Re-homing may be the best option sometimes. Though it’s difficult to accept, don’t delay after coming to this conclusion. You’ll want to find your companion a new home and keep them out of the shelter. Let us help.

Here are some signs that it may be time to find a new home for your pet include:
1. You are concerned for the safety of your family and you don't have the time or money to work with the pet and trainer to resolve.
2. The environment does not meet your dogs needs
3. You can no longer afford to provide the dog with proper care
4. Your health is being compromised

The Home to Home Program will keep dogs out of the shelter and prevent healthy dogs from being euthanized.

Your Information
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Street Address: *
Your answer
Address Line 2: (if needed)
Your answer
City: *
Your answer
State: *
Your answer
Zip: *
Your answer
Primary Telephone: *
Your answer
Your Dog(s)
Dog's Name(s): list all here) *
Your answer
Age(s): *
Your answer
Breed(s): *
Your answer
Male/Female and Spayed/Neutered (please describe sex and if altered below): *
Your answer
Up to date on shots *
Veterinarian's Name *
Your answer
Your Situation
Are you need temporary assistance to keep you and your pet together? *
If you answered yes above, please explain how WILD Canine Rescue and its volunteers might be able to help you keep you and your pet together?
If you answered yes above for temporary assistance, please explain the reason for your need:
Your answer
If you answered no to temporary assistance, it must mean you are looking for assistance from WILD Canine Rescue to help you rehome your dog. Is this correct?
If this is correct, please give us more information why you are needing to rehome your dog?
Your answer
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