ADOPTION APPLICATION

The first step in the process of adopting is completing the adoption application. The application provides important information to help find a pet well-suited to your lifestyle. A home check is also required, and will be arranged once the application is reviewed. Please provide detailed information for all questions to keep the adoption process running as smooth as possible :)
To qualify for Adoption, you must:
•Be at least 21 years old and have a valid driver's license or state Identification Card stating your current address.
•Have the knowledge and consent of a landlord, if relevant.
•Be able and willing to spend the time training, working with and giving the pet time, affection, and allowing the pet to be a part of the family.

Today's Date

MonthDayYear

Animal you are interested in

Full Name

First NameLast Name

Occupation

Please list all persons living in the home. INCLUDE: FULL NAME, AGE, AND RELATIONSHIP TO APPLICANT

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number Home

Area CodePhone Number

Phone Number Cell

Area CodePhone Number

E-mail

Driver's License Number

Do You Rent or Own?

Do you have a fenced in yard? Small, Medium or Large?

Are you planning on moving anytime soon?

If renting, may we contact your landlord?

Landlord Name

First NameLast Name

Landlord's Phone Number

Area CodePhone Number

Please list all other pets in your household, their breeds and ages.

Are your current dogs up to date on vaccinations?

Are your current pets spayed/neutered?

If your pets are not fixed please explain why.

Please provide your current Veterinarian information, including the phone number

May We Contact Your Vet?

Please list any pets you have owned prior to your current pets, including where the pets are now. This will help us to establish your pet ownership history.

How much are you willing to spend on your pet in the even he/she falls ill?

Have you ever surrendered a pet to the shelter?

Explain why you surrendered the pet to the shelter.

Explain where your new pet will sleep (i.e. in a crate, separate room etc.)

Explain where your new pet will be kept during the day when you are not home.

Explain what behavior issues would be a problem for your household.

What are you looking for in a pet? Personality traits, etc?

Desired Level Of Activity with New Dog

Dog Preference Information

Do You Agree to Try Training if Your New Dogs Needs It?

Please list a personal reference that can attest to the care of your pets and your love for animals. Please include a phone number. (Preferably not a family member.)

Is there any additional information you would like to share?

I also understand and agree that I must undergo a home-check to be done by BLBBR designee prior to any pet I am looking to adopt.

I agree to seek veterinary care, follow up and/or check-ups when necessary and follow the standard animal care protocol for my new pet.

I hereby authorize my Veterinarian/Clinic, listed above, to release any and all information on file. This can include, but is not limited to, vaccination history, heartworm prevention, treatment history, release of names and information of animals that are not listed on this application but listed with my Veterinarian/Clinic.

I understand that once the adoption contract is signed and dated, B and L Bullies and Broken Hearts Rescue and all of its representatives are absolved from any liability in reference to a dog listed with BLBBR.

I agree that the adopted animal will not be used in any illegal activities nor be found at any time in a municipality where its breed presence is illegal.

I agree that the adopted animal is to be kept as a house pet, as part of the family. The animal shall not be sold for any reason. If I can no longer keep the animal, I will contact BLBBR and make arrangements to return the animal to BLBBR.

I understand that the adoption fee is $175.00 and is due at the time of receiving the animal. The adoption contract is a legal binding contract in which B and L Bullies and Broken Hearts Rescue is legally lifted as owner of the animal, and ownership is transferred to the adopter once signed and dated. The contract will be completed once a meet and greet is arranged and all parties feel the said animal is a good fit for the family.

By signing (typing your legal name) in the space below, you are certifying that all information is correct and true and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print this for your records and retain as verification of your application.

First NameLast Name

BowWow Verification