Pet Adoption Application Form

Dog Adoption Application

Perspective Pet Parent

First NameLast Name

Name of Pet You Wish to Adopt

Email Address

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?

Pet Name(s)

Pet Breed(s)

Please provide your veterinarian's name and phone number:

Do you own or rent your home?

Do you have a fenced yard?

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?

If you rent, please provide your landlord's information here:

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?

Are there children in the home? (If yes, please list ages)

How many hours per day would the pet be alone?

Will you crate your pet?

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?

Please provide the names, emails, and contact numbers for 3 personal references:

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?

If you answered "Yes" please provide a detailed description:

By clicking the submit button, I agree to Pits R Us All Breed Rescue & Adoptions adoption process, will undergo a homecheck, and interview at the discretion of Pits R Us All Breed Rescue & Adoptions.
By clicking the submit button, I understand Pits R Us All Breed Rescue & Adoptions has the right to check my references including veterinary and personal as listed above.
By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Pits R Us All Breed Rescue & Adoptions. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
By clicking the submit button, I understand there is no "trial" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Pits R Us All Breed Rescue & Adoptions BY EMAIL and provide a 14 day period to allow Pits R Us All Breed Rescue & Adoptions to make arrangents for my pet to be taken back into rescue. I understand and agree not to rehome the pet or surrender the adopted pet to a shelter.
By clicking the submit button, I agree to indemnify and hold harmless Pits R Us All Breed Rescue & Adoptions against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By clicking the submit button, I understand that Pits R Us All Breed Rescue & Adoptions will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Pits R Us All Breed Rescue & Adoptions and provide transport to where Pits R Us All Breed Rescue & Adoptions deems appropriate.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent