Adoption Application
Bella and Sunshine Rescue, Inc. has the right to refuse the adoption of any animal to any person.
Your Name
*
First Name
Last Name
Your Age
*
Your Gender
Male
Female
Prefer Not To Say/Non-Binary
Your Email
*
example@example.com
Your Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Phone #
*
Is your Phone # a Mobile #? If so, can we text you?
*
Mobile; yes please text me
Mobile; please do not text me
Its a Landline
What is the best day/time to reach you?
*
Which animal are you interested in adopting?
*
Are you familiar with the breed of the pet you are interested in adopting?
*
Yes
No
Please explain your experience with the breed you are interested in adopting:
Your Veterinarian's Name
Your Veterinarian's Phone #
How long have you been using this veterinarian?
Is your name and address provided above the same as the one used at your veterinarian’s office?
Yes
No
What is your contingency plan for paying unexpected vet bills? Explain:
*
Do you own your home or rent?
*
Own
Rent
Does your Landlord/HOA Allow the breed you are interested in adopting?
*
Yes
No
Not sure
Do you have a fenced yard?
*
Yes
No
If you have a fenced yard, how high is the fence at the lowest section?
What kind of fence is it?
If you do not have a fence, do you plan to install one?
Yes
No
Not Applicable
If you do not have a fence, how do you plan to have your new animal relieve itself and exercise?
Do you have an in-ground pool or jacuzzi in your yard?
*
Yes
No
I don't have a yard
If yes, is the pool/jacuzzi fenced?
Yes
No
Is everyone in your household aware of your interest in adopting an animal and does everyone agree to adopt the pet into the household?
*
Yes
No
How many adults (age 18+) are there in the household? (Including yourself.)
*
Please provide the names of all the adults in the household:
*
How many children (under 18 years of age) are there in your household?
*
Do you plan to add any children to your household in the next 5-10 years? (Whether it is a relative's children or your own children/grandchildren.)
*
Yes
No
Does anyone in your household have allergies to or may be allergic to dogs/cats?
*
Yes
No
Has a member of your household been convicted of an animal welfare law violation such as neglect, cruelty, abandonment, or otherwise?
*
Yes
No
Who are you adopting the animal for?
*
Are there any cats in your household?
*
Yes
No
Are they indoor or outdoor cat(s)? Explain:
Do you currently have other animals in the household?
*
Yes
No
List their species, age, and sex of other animals in the household:
On a regular day, how many hours will the animal be left alone?
*
How many hours each day will you spend with the animal?
*
How often will you exercise the animal and for how long?
*
What energy level would you say your lifestyle is?
*
Not Active
Moderately Active
Very Active
Where will your animal be kept when it is left alone?
*
Where will your animal be kept during the day when not left alone?
*
Where will your new animal sleep?
*
Will the animal be allowed on furniture?
*
Yes
No
Do you get a lot of visitors (human and pets) in your household?
*
Yes
No
If you get visitors, who / what would that usually be?
Any career / educational changes planned in the next 5-10 years?
*
Yes
No
If yes, please explain:
Have you ever worked with an animal trainer to help with training your pet?
*
Yes
No
If a behavioral problem arises, would you be willing to take the animal to training and/or obedience classes?
*
Yes
No
Are you willing to obtain an appropriately sized, open wire crate if recommended?
*
Yes
No
Do you have someone to care for your animal when you are on vacation?
*
Yes
No
Large breed dogs are expensive to feed, and vet bills are expensive when they require medical care. Do you warrant that you are financially capable of meeting all the needs of the animal(s) you are applying to adopt?
*
Yes
No
Please provide a reference #1 (name and phone/email)
*
Please provide a reference #2(name and phone/email)
*
Please provide a reference #3 (name and phone/email)
By signing my name below and clicking "Submit", I certify that I have answered the above questions truthfully and to the best of my ability. I grant Bella and Sunshine Rescue, Inc. the permission to verify any and all information provided on this application. If at any point AFTER the adoption of this pet it is discovered that any statements made to Bella and Sunshine Rescue, Inc. were false, we have the right to confiscate said pet from your home, making the adoption void. I further warrant that I am financially capable of meeting all the needs of the animal(s) I am interested in adopting.
Continue
Continue
Should be Empty: