TLC Rescue: Dog Adoption Application

Brazil-USA Pet Lovers Rescue

Dog Adoption Application
Thank you for considering the adoption of a pet from the Brazil-USA Pet Lovers Corp. rescue organization (“BPL”) (1). Adopting is the most compassionate and responsible way of bringing an animal into your home. The following information is requested to help BPL determine if the adoption is in the animal's best interest and to assist you in finding an animal most compatible with your lifestyle.

To be considered as an adopter, you must:
• Be 21 years of age or older
• Have identification showing your current address
• Have proof of home ownership or the consent of your landlord or homeowners/condo association, if applicable
• Be able and willing to spend the time and money necessary to provide training, medical treatment, and proper care for a pet

Adoption fees paid to BPL help defer the cost of food, shelter, equipment and medical care, including spay/neuter surgery, age appropriate vaccinations, de-worming medication, heartworm testing and preventative treatment, and flea and tick preventative treatment administered while the animal is in our care. BPL is an all-volunteer organization and it depends on adoption fees and donations of time and shelter from its foster volunteers to assist dogs and cats in need of a forever home.

(1) BPL is a charity registered as a corporation in the State of Connecticut and recognized as a 501 (c) (3) organization under the United States Tax Code.
Name of the dog you want to adopt (BPL name of dog)
Adopter's Name*

First NameLast Name
Place of Employment
Co-Adopter's Name

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Adopter's E-mail*
Co-Adopter's E-mail
Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Do you rent or own this property?*

RentOwn
How long have you lived at this address?
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeApartment
Renters & owners living in condos or townhouse communities, have you contacted your landlord/management company to find out if there are any restrictions on the breed or size of dog you can have?

YesNoNot yet, but I willIt's written in our lease
If you rent, you must show us a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have dogs and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have a dog there and show any restrictions.
If you would like to upload proof of ownership (i.e. property tax or water bill, mortgage statement, etc.), a section of a lease or homeowners association document detailing approval for pet ownership (and any restrictions) or a letter from your landlord, please use the link below. Having these documents available when your application is reviewed will greatly expedite the process.

Browse Files

Cancelof
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
If yard is fenced, what is your fence height?

2' high3' high4' high5' high6' high
Names and ages of all permanent residents of your home (adults/children)
Name 1*

First NameLast Name
Age person 1
Name 2

First NameLast Name
Age person 2
Name 3

First NameLast Name
Age person 3
Name 4

First NameLast Name
Age person 4
Name 5

First NameLast Name
Age person 5
Additional Names and ages of all permanent residents of your home (adults/children)
Is anyone in your home allergic to dogs?*

YesNo
Does anyone in your home fear dogs?*

YesNoOther
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a dog added to the family. Please do not submit this application if you are "trying to talk someone into" adopting this dog or think "once they meet the dog, they will want one" or "I'm getting this dog as a surprise birthday present for them." In those scenarios, you are welcome to email us to discuss the dog, but we would like all adults in the home to be involved in that email discussion.
Pet experience - present and past
Do you currently have any pets?*

YesNo
If you currently have pets, please list them below.
Are your current pets or altered?*

YesNo
If your current pets are not altered, please explain why below.
Did you have pets in the past? If so list breed and why they are no longer with you as well as whether they were altered.
Do you work outside the home?*

YesNoOne applicant is home/works from homeWe work different shifts
If you both work outside the home, how many hours per day will/are the dog(s) be alone?*
If the dog will be left alone, do you plan to crate the dog or use some other means to manage the level of access it has in your home?
How do you plan to integrate this dog into your family?*
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family?*
Do you plan to take formal obedience classes or hire a trainer if required?*

YesNo
Veterinary Care
Vet Practice you currently use or used in the past? (please call your vet and give permission to release information to us)*
Vet name, address & phone number
Name of Veterinarian

First NameLast Name
Do you plan to get pet health insurance?*

YesNoI wasn't aware this was available. I will look into it.
Dogs can live 15 years or longer. Are you willing to commit to caring for an animal that long? Who would care for the animal if you were no longer able to provide for its care?*
Adoption
Our foster volunteers care for the Rescue's dogs in a home environment. A home setting provides a less stressful environment than a shelter setting, ensures the animal is exposed to the normal rhythm of family life and allows our fosters an opportunity to begin to evaluate the animal. While BPL’s foster volunteers make reasonable efforts to test the dog’s level of socialization with other dogs, people and, when possible, cats and will communicate what they have observed to prospective adopters verbally and, where possible via text, email or other electronic means, you should understand the BPL’s volunteers can only report behaviors they have directly observed. Because the history available on the dog you have applied to adopt may be incomplete or not available, BPL cannot guarantee how this dog will react with dogs and people unfamiliar to the dog including children. Therefore, it is necessary for you to supervise the dog you adopt when it is with other animals and other members of your household, especially children, until you are satisfied that both the dog and other household members are comfortable with each other.

The dog you have applied to adopt needs time to adjust to a new home. It may take this dog a few weeks to adapt to its surroundings. Patience and understanding should be used in the event of accidents and mischievous behavior. As the adopter you should not immediately expect a perfectly behaved dog. It is up to you, the new owner, to reinforce and train your dog's behavior over a period of time.

While we thank you for potentially opening your home to a rescue animal, we ask you to carefully consider the responsibilities of animal ownership. Regardless of whether you adopt your dog from a breeder or a rescue, individual dogs have their own personailties, energy levels and training needs. Please consider the following questions carefully as you prepare to meet the dog you wish to adopt so you can help the Rescue the adoption is a good fit for both the animal and its new family.
What activity/energy level do you prefer?*

Wild and crazy is coolLeash trained daily jogging partner would be excellentMedium energy, plays a bit then hangs out with youLow energy, walks slowly on leash, a total couch potatoOther
How long have you been looking for a dog?*
Please check all that apply. I want to adopt this dog...*

As a family petTo breed with my dogTo train/use for huntingTo train/use for agilityTo train/use as a therapy dogTo train/use as an assistance dog for the disabledTo use as a guard dogFor a jogging/hiking partnerTo interact with lots of friends/familyAs a gift for a friend, partner, or family memberAs a companion for my dog(s)As a companion for my cat(s)As a companion for my child/children
Upon meeting the dog, what would give you cause to not want to adopt it? Please explain.*
What would cause you to return a dog?*
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the dog?*

HousebreakingChewingJumpingPulling on leash during walksCounter surfingObedience trainingFear of men/womenFear of childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my dogHigh activity levelFood/toy aggression/not willing to share with other dogsFood/toy aggression with peopleWhining/cryingCounter surfingSeparation AnxietySpecial DietIncontinence / Leaking UrineTaking classes with the dogGets stressed/carsick when riding in vehicleDoesn't know how to climb stairsAllergiesI will do whatever it takes to help this dog adjust and work with a trainer to help resolve any training needs.
When will you be ready to adopt this dog?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Are you in contact with any other rescues or shelters about a specific dog?*

Yes, application is pendingYes, just an email inquiry, no app yetNo, but I am looking at several dogs onlineNo, I am only interested in this particular dog
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a dog?*
I understand that BPL reserves the right to approve or deny any adoption application, and the completion of this application does not guarantee an adoption of a BPL animal. I affirm that I have answered all questions truthfully and to the best of my knowledge. I also represent that I am willing and able to accept full and immediate responsibility, if approved, for the ownership and care of the animal I am applying to adopt. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from BPL to contact my vet for a reference and also agree to allowing a home visit prior to adopting this dog. If I am approved to adopt a dog, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption.

I understand that all dogs adopted from BPL will be spayed/neutered and vaccinated, consistent with the requirements of the State of Connecticut, prior to adoption
Please read the above, check this box, sign, and click Submit.*

I/We have read and understand all of the above.
Applicant's Signature*
Co-Applicant's Signature
Signature date*
After you submit this form, you will receive an email confirming its receipt. Please allow 24 hours for BPL to review your application and contatct you. If you hav eany questions you may contact BPL at

Contact-saveadogslifenow@gmail.com

BPL reserves the right to reject any application based on information obtained during this screening process. Please understand that our primary goal is the health, happiness, and safety of our rescued dogs.
Should be Empty:

Brazil-USA Pet Lovers Rescue

Names and ages of all permanent residents of your home (adults/children)

Pet experience - present and past

Veterinary Care

Adoption