ADOPTION APPLICATION
Please fill out the application form honestly and completely. We cannot process incomplete applications. Though the application is one step in our adoption process, it is the first opportunity we have to get to know you and it is an important part of our being able to make the best adoption match. YOU MUST BE 21 YEARS OF AGE TO APPLY.
DateTime
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Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Occupation
*
Your age
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By checking YES, you agree that the dog will not be used for any illegal activities nor found at any time in a municipality where there is a breed ban.
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YES
NO
By checking YES, you agree that the dog is to be kept as a family pet and shall not be used for medical or any other experimental purposes.
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YES
NO
What dog(s) are you interested in adopting? List them below:
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Have you already spoken with an MABBR volunteer about the dog(s) you are applying for? If so, who?
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Why do you want to adopt a dog?
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How soon do you want to adopt?
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Do you prefer a male or female?
Male
Female
Either
Do you prefer an adult or puppy?
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Adult
Puppy
Either
What energy level works best with your lifestyle?
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Active
Mellow
Do you have a color or weight preference?
*
Do you own or rent your home?
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Own
Rent
Live with parent(s)
Choose the type of dwelling that best describes your home:
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House
Apartment
Townhouse
Duplex
Mobile home
Describe your yard and fence type (privacy, chain link, etc.)
*
Does your landlord allow pets?
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Yes
No
Are you required to pay a pet deposit?
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Yes
No
Does your landlord know you are looking for a new pet?
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Yes
No
Please provide your landlord's name and phone number. We cannot process your application without this information.
*
Tell us about the members in your household. List all household members, including their age and relationship to you. (Example: Mary, 12 years old, daughter)
*
Are all the members of your household in agreement about adopting a new pet?
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Yes
No
Do you currently own any pets?
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Yes
No
List your current pets below. Please be specific with TYPE, AGE, SEX AND BREED:
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Are your current pets spayed or neutered?
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Yes
No
Please tell us why your current pets are not spayed or neutered:
*
Tell us about the pets you have owned in the past:
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Have you ever had to rehome a pet? If so, please explain the circumstances:
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What circumstances would prevent you from keeping a pet for the rest of its life?
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What would you do if you could not keep your pet?
*
Do you have a contingency plan in place for your pet(s) if something were to happen to you? Please explain.
*
How many hours a day will your new pet be home alone?
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Where will your new pet be kept at night or when you leave your home?
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Do you travel for business or vacation?
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Yes
No
Who will provide for your pet(s) while you are away?
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What traits would you find unacceptable in your new pet?
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What steps would you take to correct unwanted behavior?
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Are you willing to work through unexpected hardships with your pet? Would you be willing to hire a trainer if needed?
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Yes
No
Not sure
Describe any experience you have had with obedience training or with medical or behavioral issues:
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What kind of activities do you or will you do with your pet(s) for fun and/or exercise?
*
What restrictions would you place on your pet's interaction with children?
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What restrictions would you place on your child(ren)'s interactions with your pet?
*
Of all the breeds available, why are you interested in adopting a pit bull?
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Please describe any experience you have had with pit bulls or bully breed dogs:
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Do you know what Breed Specific Legislation is?
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Yes
No
Tell us in a few words what you know about Breed Specific Legislation:
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Tell us how you feel about Breed Specific Legislation:
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Does the city you live in have Breed Specific Legislation? If so, please describe the ordinance and its restrictions:
*
Have you thought about and are you prepared to deal with the discrimination that may come from owning a pit bull or bully breed dog, i.e. homeowner's insurance, neighbor relations, community bias?
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Are you prepared for the financial responsibility that comes with owning a pet?
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Yes
No
Please supply the name and phone number of your current veterinarian:
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Please supply the name and phone number of an employer, friend or someone NOT related to you that can attest to your character:
*
Are you willing to travel to meet your new pet? If so, how far?
*
Please provide any additional information you would like us to know about your home, family, pet(s), etc.:
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How did you hear about MABBR?
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Submit
Should be Empty: