Bullies-N-Beyond Rescue, Inc
Completion of this application does not guarantee adoption of an animal.
Applicant Information
Your full name:
*
Name of the dog you are interested in:
*
Describe in detail the animal you are applying to adopt:
Street Address:
*
City, State, Zip
*
Your age:
*
E-mail:
Cell Phone:
-
Area Code
Phone Number
Occupation:
Will this be your first dog/cat?
Yes
No
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
What kind of pets have you had in the past?
Which of these pets do you still have? (Include age, sex, and breed)
Have they been spayed or neutered?
Yes
No
Don't know
Are they current on vaccinations?
Yes
No
Don't know
What happened to the pets you no longer have?
Have you ever turned your dog into a shelter?
Yes
No
If yes, please explain:
Have you ever had a pet euthanized?
Yes
No
If yes, please explain:
If you have pets, will they (he/she) adjust to a new dog in the house? (Please explain)
Was your last dog obedience-trained
Yes
No
Doesn't apply
Why do you want this dog?
Companion
Companion for other pet
House pet
Watch dog
Guard Dog
Hunting
Personal protection
other
How many adults are in your home?
Occupation of those living in your household (spouse/boyfriend/ girlfriend)
How many children?
Children's ages?
Is everyone in your household ready to adopt a new family member?
Yes
No
Does any member of your household have an allergy to dogs?
Yes
No
Is someone home during the day?
Yes
No
If yes, who?
How many hours each day will the dog be without human companionship?
Please explain:
Where do you live?
House
Apartment
Condo
Mobile home
Other
If other explain:
Do you rent or own?
Rent
Own
If rent please list the owner's name and phone number:
Does anyone smoke in the house?
Yes
No
Do you have a completely fenced yard?
Yes
No
Is there a gate?
Yes
No
What kind of fence?
Height of the fence?
If no fenced yard, please explain:
Do you have a dog door?
Yes
No
Are there times when the dog will be tied up?
Yes
No
Type option 3
Type option 4
If yes, when?
Is there stairs that lead up to your home?
Yes
No
If yes, how many?
Will the dog spend any time in the garage?
Yes
No
If yes, please explain
Do you have a pool?
Yes
No
If yes, is there a fence around the pool?
Yes
No
If your new puppy/dog is not housebroken, what method will you use to train him/her?
Will you keep the dog up-to-date on vaccinations?
Yes
No
Who is your veterinarian, Phone number, City/State
Are you able and willing to exercise the dog?
Yes
No
If yes, method?
Where will the dog be kept during the day?
Where will the dog be kept during the night?
If you drive a pickup truck, would you allow the dog to ride in the back?
Yes
No
If you go away for a few days, or on a vacation, who will take care of the dog?
If you move will you take the dog with you?
Yes
No
Please explain
How much are you willing to spend on medical bills for your dog?
Up to $100
Up to $500
Up to $1,000
Up to $5,000
Whatever it takes
What if the vet bills went over this amount?
Are you willing to take responsibility for this dog for the next 10-15 years?
Yes
No
If no, explain:
What provisions will you make for the dog should you become unable to care for him/her?
Additional comments from applicant:
Submit
Should be Empty: