Brittany Foundation Adoption Application
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Which dog would you like to adopt?
Who shares your household? Please provide the first name and relationship of each person living in your home.
Who shares your household?
Spouse or Significant Other
Children
Roommate
Other
Ages of children, if any, who live in your household
Where do you live? (city)
Type of dwelling
House
Apartment
Condo
Townhouse
Other
Do you rent or own?
Rent
Own
If renting, are dogs allowed?
Yes
No
N/A
What is your occupation?
What is the occupation of your housemate?
Who is more the "dog person," you or your housemate?
If your present relationship were to change, with whom would the dog remain?
At what age do you feel children are responsible enough to care for a dog without assistance (walk, feed, etc)?
Is anyone in your household allergic to dogs?
What percentage of time will the dog be in the house? In the yard?
Which rooms, if any, are off limits to the dog?
Is the dog allowed on the furniture?
Where will the dog sleep at night?
When you go to work, where will the dog be?
House
Yard
Other
When you go on vacation, who will care for the dog?
House sitter
Pet sitter who does not stay
Vet
Kennel/boarding
Friend's house
Friend feeds but does not stay
Other
Do you have a doggie door?
Yes
No
If you do not have a doggie door, will you install one for your new dog?
Yes
No
Is anyone home during the day? If so, who?
How many hours will the dog be alone during the day?
Do you have a gardener?
Yes
No
Do you have a person who cleans the pool?
Yes
No
N/A
If yes, where will the dog be while they're working?
Do you trust these workers not to let the dog out?
Yes
No
N/A
Does the meter reader enter your yard when you're not home?
Yes
No
Do you have a housekeeper who enters your home when you're not there?
Yes
No
If yes, how long have you had this housekeeper?
If you rent, does your landlord have a key to your house?
Yes
No
N/A
If you rent, does your landlord have a key to your gate?
Yes
No
N/A
If you rent, does your landlord have access to your home without your permission?
Yes
No
N/A
Do you share your yard with other tenants?
Yes
No
N/A
Do you have a fenced back yard?
Yes
No
Do you have a fenced front yard?
Yes
No
What type of fencing do you have?
If chain link, wood, or iron, what is at the bottom of the fence?
Dirt
Grass
Cement
Other
How high is the fence at its highest point?
How high is the fence at its lowest point?
How high is your gate?
Which of the following is used to secure your gate?
Latch
Keylock
Deadbolt
Padlock
Other
During a 24-hour period, when is your gate locked?
Days only
Nights only
Only when I leave the house
At all times
Other
I don't lock my gate because:
I live in a safe neighborhood
I (and/or my housemate) use it a lot
My kids or other household members use it a lot
Meter readers or other workers must enter
N/A
Other
If your dog has gotten out, which of the following did you do?
Check shelters
Use social media to look for the dog
Put up signs
Flyers door to door
Wait, because my dog might come back
N/A
Other
Will you feed your dog canned or dry food?
What brand of dog food will you feed your dog?
Will you feed your dog "people food?" If so, what kind?
Who in your household will be mostly responsible for feeding the dog?
How many times per day will you feed the dog?
Once
Twice
Three times
What do you think is a good way to keep your dog's teeth clean?
Never really thought about it
Do it myself
It's not necessary
Feed dog biscuits
Have the vet do it
Other
What will you use for flea and tick control?
Have you ever trained a dog in obedience class?
Yes
No
If yes, what training methods did you use?
Do you still use these training methods?
What method do you use to housebreak your dog?
In which of these situations are you able to have your dog off leash?
Park
Hike
Beach
Neighborhood walk
My front yard
Other
What discipline will you use if your dog chews your favorite shoes?
Which of the following disciplines will you use if your dog just won't listen and is really naughty?
Spank with hand
Spank with newspaper
Swat nose
Stern voice
Scruffing
Other
When will your dog wear a choke chain?
Always
Never
Only on walk
Other
Do you think it's necessary for your dog to wear an ID tag?
Yes
No
If yes, what kind?
License
Vet/Rabies
Microchip
Owner's contact info
What is the name and location of your veterinarian?
Which of the following would force you to give up your dog?
Move locally
Move out of state
Move overseas
None of these
Under what circumstances would you not keep your dog?
Divorce/separation
Allergies
Dog barks a lot
Dog digs a lot
Dog nips at strangers
Dog bites kids
Dog loses control of bladder
Dog develops chronic illness
Big vet bills
Dog is just untrainable
Dog is not the kind of dog I thought it would be
Having a baby
Other
If you've been forced to give up a dog in the past, what did you do?
Gave to relative
Gave to friend
Gave to adoption group/rescue
Gave to shelter
Found home through newspaper or social media
Other
Please describe your animal history. List the animal, length of ownership, and if you still have the animal; or if you no longer have the animal, what happened.
How did you find us?
Driving by
Ad in newspaper or magazine
Facebook
Instagram
TikTok
NextDoor
Petfinder
Adopt-a-Pet
Referral
Other
Is there anything else you would like us to know?
Submit
The Brittany Foundation Animal Sanctuary
PO Box 738, Acton, CA 93510-0738 | 36220 Anthony Road, Agua Dulce, CA 91390
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