Membership Application Form

Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Phone Number

Area CodePhone Number

1) Reference Name

1) Reference Phone Number

Area CodePhone Number

2) Reference Name

2) Phone Number

Area CodePhone Number

How did you hear about us?

What is your preference in regard to age, sex, or other requests?

What do you know about English Bulldogs?

Why are you interested in adoption?

How long have you lived at the address listed?

Residential Status

RentOwn

If you rent, please provide landlord's name and number:

How many adults live in the household?

Do you have any children in the home or that visit on a regular basis? If yes, what are their ages?

Does anyone smoke in the home?

YesNo

Have you ever owned an English Bulldog?

YesNo

If no, please describe a time you have encountered an English Bulldog.

Option 1Option 2Option 3

Please list the type, breed, age and sex of ANY animal in the home and indicate if they are spayed or neutered.

Are household pets current on vaccinations?

YesNo

Do you have a fenced yard?

YesNo

Where do you plan on keeping your English Bulldog?

How will your pet use the bathroom? (Fence, leash, paper train, etc):

What will you do with your pet when no one is home?

We require adopted animals to be spayed or neutered. Do you have any reservations or concerns about this policy?

What will you do if your pet exhibits bad behavior? (Destructive, soils the house, barking, etc)

Are you willing to give this pet at least 30 days to adapt to his or her new environment and family?

YesNo

This animal may not be housebroken. Are you willing to take the time to work with the animal?

Please provide the name, address and phone number of your veterinarian.

Would you be interested in information about crate training?

YesNo

Why or why not?

Feel free to leave additional comments here:

Adoption & Foster Application