Adoption Application

BBB CANINE RESCUE & TRANSPORT ADOPTION APPLICATION
Please provide us with your contact information.
Name*

First NameLast Name
Spouse's Name (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City*
Province*
Postal Code*
Phone Number*

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
When is the best time to call?*
Email
example@example.com
Please tell us about yourself.
Name of dog you are applying for?
Please leave the field empty if you do not have a specific dog in mind.
If you do not have a specific dog in mind, please describe the characteristics you are looking for?

Why do you want to adopt a dog?*
Do you currently have pets?*
If yes, please list the type(s),breed, gender, spayed/neutered or declawed:
Have you had pets in the past that are no longer with you?*
If yes, tell us about some of the pets you have owned:
If you currently have pets, what brand of food do you feed (canned, dry, home cooked, raw)
Have you ever had to find a new home for one of your pets?*
If yes, what were the circumstances?

Veterinarian information.

Which veterinarian looks after your pets currently or has in the past?
Clinic Name:
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City
Province
Postal Code
Can we contact your veterinarian for a reference?
If yes, please contact your vet to give them permission to speak with us.
Are your current pets currently on flea/heartworm prevention?
If yes, what brand/ manufacturer are you using?
Home & Household information.
How many adults live in the home?*
What are the work hours for each adult?*
How long long would the dog be left alone each day?*

ADDITIONAL INFORMATION
How did you hear about us?*
If Veterinariany reference supplied above, please provide us with one additional personal reference that is not an immediate family member.

If no Veterinariany reference supplied above, please provide us with two personal references that are not immediate family members.
Reference #1 Name:*
Phone number:*
Relationship*
Reference #2 Name:
Phone number:
Relationship
Please provide us with any additional information you feel we should know:
BY SUBMITTING THIS APPLICATION, I UNDERSTAND THAT THE COMPLETION OF THIS APPLICATION DOES NOT GUARANTE THAT I WILL BE APPROVED.
I HEREBY AUTHORIZE BBBCRT TO VERIFY THE ANSWERS GIVEN IN THIS APPLICATION. PLEASE ACKNOWLEDGE BY CHECKING THE BOX BELOW.
Date*

MonthDayYear
Date
Should be Empty:

BBB CANINE RESCUE & TRANSPORT ADOPTION APPLICATION