Adoption Application

Bully Smiles Inc.

Adoption Application, Contract and Waiver

PLEASE DO NOT COMPLETE THIS APPLICATION UNLESS YOU ARE WILLING TO COMMIT NOT TO ADOPT ANOTHER DOG FOR THE NEXT 24 HOURS!

9 out of 10 people adopt elsewhere (which is fine) though it wastes our time. Please do not do that!

Perspective Pet Parent/Adoptee (Please only list one primary applicant)*

First and Last NameAdopter Age

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)

When was the last time your pet(s) had puppies/kittens?

Tell us about your current pet(s)

Please provide your veterinarian's name and phone number, as well as your account number:

Do you own or rent your home?*

OwnRent

Do you have a fenced in yard?*

YesNo

If you do not have a fenced yard, how do you plan to exercise your pet?

What heartworm/flea/tick prevention do you use?*

Do you have a HOA or agreement that lists the types or sizes of animal allowed?*

Have you surrendered a pet to a shelter or rescue, in the past 10 years?*

YesNo

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

How many hours per day would the pet be alone?*

Will you crate train your pet?*

If you have to leave town, emergently or planned, where would your pet stay?*

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

(This question is for Pit Bull/Boxer/Bulldog types) Are you willing to participate in a minimum of 2 training classes with a professional dog trainer? For some dogs, this is a requirement.*

YesNo

What would happen to this pet incase of a divorce or separation? *This is something we have had a lot of issues with lately, so unfortunately we need to address it* :*

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

YesNo

If approved, When would you be ready for this pet to go home with you?

By clicking the submit button, I agree to Bully Smiles Inc. adoption process, will undergo a homecheck, and interview at the discretion of the rescue.
By clicking the submit button, I understand the rescue will check my references including veterinary, personal.
By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
By clicking the submit button, I agree to indemnify and hold harmless Bully Smiles Inc. 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 Bully Smiles Inc. 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 notify the rescue and provide transport to Chickamauga,GA as the rescue deems appropriate.
I acknowledge that the rescue may not always be able to take a animal back on immediate notice, or at all based on the reason, and I need to communicate any potential issues with the rescue.
I acknowledge that I may return any animal within 30 days of adoption, though that spot will be filled on day 31.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*

Feel free to list any other information you feel we should know about the life your prospective new pet will have.