Brave Dog Rescue Application

ADOPTION QUESTIONNAIRE AND APPLICATION
PLEASE FILL OUT THIS APPLICATION ON YOUR COMPUTER, NOT SMARTPHONE
This questionnaire is designed to help Brave Dog Rescue and yourself determine if a specific pet is the right one for you and your household. All adopting parties are required to complete this form in its entirety prior to adoption. Brave Dog Rescue reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!
Applicant Information
Name of the pet you are interested in:
Your full name:
Your age:
Street Address:
City, State, Zip
Home Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:
Occupation:
Household Information
Name of spouse (or partner if you reside in the same home) and their occupation:
Are all members of your household in agreement with this adoption?

YesNoDon't Know
How many adults are in your household?
How many children are in your household?
If children, what are their ages?
If children, have they been around animals before?

YesNoN/A
Please list any other occupants in your home:
Is anyone in your home allergic to pet dander or have asthma?

YesNo
Does anyone in your home smoke?

YesNo
What is your primary reason for adopting a pet?

Companion for you/your childrenCompanion for another petWatchdogOther
Who will be the pet's primary caregiver?
What type of dwelling do you live in?

HouseCondoApartmentOther
Do you own or rent?

OwnRent
If rent, does your landlord allow pets?

YesNoI don’t knowN/A
If rent, please provide name and phone number of landlord:
Are there any restrictions from your landlord, HOA or subdivision?

Number of petsSize or weight restrictionsBreed restrictionsNoneN/AOther
What outside areas will be available to your new pet?

YardPatioBalconyGarageN/AOther
Are all outside areas where your new pet will be allowed, fenced?

YesNoN/A
Type of fence:

Chain linkConcrete/Brick/StoneWoodN/A
Height of fence at the lowest point:
Are there any gates/number of gates:
Height of gate(s) at the lowest point:
Are gates kept locked?

YesNoN/A
Who else has access to the yard (Gardner, Pool man, Neighbor, etc?)
Do you have a doggy door?

YesNo
Do you have a pool?

YesNo
If yes, is your pool gated?

YesNoN/A
Do you keep rat poison in your home and if so, where?
Current/Previous Pet Information
Please list all pets you've owned as an adult, length of time and what happened to them:
Please list all current pets: Name, species and age:
How many of these pets are spayed/neutered?
Have you ever given up a pet?

YesNo
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
New Pet Information
What type of personality do you want your new pet to have? (i.e. calm, energetic, protective, couch-potato)
If the pet has an "accident" in your home, what type of correction do you plan to use?
How many hours each day will your new pet be home alone?
Where will your new pet stay when nobody is home?
Where will your new pet sleep at night, specifically?
Is there any piece of furniture your new pet will not be allowed on, specifically?
Are there any areas of the home your new pet will not be allowed?
Who will take care of your new pet when you’re on vacation?
What brand and type of food will you feed (wet, dry, etc?)
Who will groom your new pet?
If dog, will your new pet wear a collar with tags?

YesNo
When will the collar be on? When will it be off?
What will you use to walk your dog?

Martingale collarSlip leadRegular collarChoke/pinch chainHarnessOff leash
How would you rate your level of experience as a dog owner?

BeginnerIntermediateAdvanced
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?

YesNo
If dog, how will you train him or her?

Firm verbal commandHit with newspaperClicker/hand signalsE-collarOther
How would you discipline your new pet if he/she misbehaves?
If dog, do you plan to take an obedience class?

YesNoNot sure
If yes, where?
Are you willing to live with hair on your furniture, stains on your rug, a warm body in your bed and an animal who might be destructive at times?

YesNo
Are you aware that pets can live up to 20 years and are you prepared to make a long term commitment for the remainder of their lives?

YesNo
Pets are an investment of time and money. Can you afford the medical care, grooming, proper diet, shelter and exercise for your new pet?

YesNo
What will you do with your pet if your current relationship breaks up?
What will you do with your pet if a new partner does not like/want them in the home?
What will you do with your new pet if you have baby?
Who will take care of your pet(s) in the event you are no longer able to?
Have you, or are you willing to make a plan for the continued care of your pet(s) should they outlive you?

YesNo
What will you do with your pet if you move to a new place locally that does not accept pets?
What will you do with your pet if you move out of the state? Country?
Which of the following reasons might prompt you to give up your new pet?

Excessive barkingDiggingBitingPoor watchdogDestructive chewingFinancial problemsEliminating indoorsGrowling at guestsExcessive billsSheddingYour new partner doesn’t likeAllergiesAggressive on leashNoneOther
Will you agree to consult with and pay for a trainer or behaviorist if problems do occur?

YesNo
If you had to give a pet what would you do with him/her?
Please provide the full name/phone number of two personal references
I understand that a home check is required prior to adoption.
I understand that a home check does not guarantee placement
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
I understand that the donation or contribution is a gift given freely and does not constitute purchase of the above named pet.
I understand that this application will become part of my contract should I adopt the above listed pet.
I understand that submission of this application to Brave Dog Rescue constitutes my agreement with all the above listed terms.
Should be Empty:

ADOPTION QUESTIONNAIRE AND APPLICATION

PLEASE FILL OUT THIS APPLICATION ON YOUR COMPUTER, NOT SMARTPHONE

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information