Adoption Application

NAME*

First NameLast Name

WHICH DOG ARE YOU APPLYING FOR?*

HOW DID YOU HEAR ABOUT BULLY UP RESCUE?*

TELL US WHY YOU WISH TO ADOPT?*

WHAT IS YOUR IDEA OF A PERFECT COMPANION?*

BRINGING A NEW DOG INTO YOUR HOME TAKES TIME AND PATIENCE. IN SOME INSTANCES, IT REQUIRES SLOWLY INTEGRATING YOUR NEW COMPANION WITH YOUR FAMILY OR YOUR CURRENT DOG(S), CAT(s), or other companions. ARE YOU WILLING TO BE PATIENT WITH YOUR NEW COMPANION AND COMPLY WITH SLOW INTRODUCTIONS (1-3 WEEKS) IF NEEDED?*

YESNO

TELL US SOME OF THE MOST IMPORTANT RESPONSIBILITIES YOU MUST DEMONSTRATE WHEN YOU OWN A "BULLY BREED"?*

ARE YOU 21 YEARS OF AGE OR OLDER?*

YESNO

WHAT IS YOUR DATE OF BIRTH?*

ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code

HOW LONG AT THIS ADDRESS? If less than 3 years, please provide previous address. *

PREVIOUS Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

EMAIL*

example@example.com

CELL PHONE*

NAME OF EMPLOYER*

LENGTH OF EMPLOYMENT*

WHAT IS YOUR WORK SCHEDULE?*

DO YOU HAVE A SPOUSE / DOMESTIC PARTNER OR OTHER PERSON LIVING AT THIS ADDRESS?*

YesNo

NAME*

First NameLast Name

DATE OF BIRTH*

EMAIL*

example@example.com

CELL PHONE*

NAME OF EMPLOYER*

LENGTH OF EMPLOYMENT*

WHAT IS THEIR WORK SCHEDULE?*

ARE THERE CHILDREN LIVING IN THE HOME OR VISITING FREQUENTLY?*

YESNO

WHAT ARE THEIR AGES?

DO YOU PLAN ON HAVING CHILDREN IN THE NEXT 5 YEARS?

PLEASE LIST ALL OTHER ADULTS WHO RESIDE IN YOUR HOME (NAME, DATE OF BIRTH & RELATIONSHIP)*

DOES ANYONE IN YOUR HOME HAVE ALLERGIES TO PETS? IF YES, PLEASE EXPLAIN*

WHAT TYPE OF HOME DO YOU LIVE IN?*

SINGLE FAMILY HOMECONDO/TOWNHOUSEAPARTMENTMOBILE HOME

DO YOU RENT OR OWN?*

RENTOWN

PLEASE PROVIDE LANDLORD CONTACT NAME AND NUMBER (Written Landlord approval is required.)

ARE YOU PREPARED TO PAY AN EXTRA PET DEPOSIT OR RENT, IF REQUIRED?*

YESNO

DO YOU RESIDE IN A HOME OWNER ASSOCIATION (HOA) OR DEED RESTRICTED COMMUNITY?*

YESNO

ARE THERE ANY BREED/WEIGHT/PET RESTRICTIONS IN YOUR COMMUNITY?*

YESNO

IF SO, WHAT ARE THE RESTRICTIONS?

DOES YOUR HOMEOWNERS' INSURANCE RESTRICT BULLY BREEDS ON YOUR PROPERTY/IN HOME?*

YESNON/A

IS YOUR YARD FENCED?*

YESNOPARTIALNO YARD

WHAT TYPE OF FENCE DO YOU HAVE? Check all that apply.*

HOW HIGH IS YOUR FENCE (APPROXIMATE FEET)?*

ARE THERE SECURE LATCHES ON ALL GATES?*

HOW WILL YOUR DOG BE EXERCISED?*

HOW OFTEN?*

ARE YOU WILLING TO POTTY TRAIN YOUR NEW DOG OR WOULD YOU PREFER THAT YOUR COMPANION IS ALREADY HOUSE TRAINED?*

WHAT IS YOUR EXPERIENCE WITH CRATE TRAINING?*

HOW MANY CONSECUTIVE HOURS WILL YOUR DOG SPEND HOME ALONE DURING THE DAY?*

IF OUR COMPANION REQUIRES A CRATE FOR COMFORT OR SAFETY, ARE YOU WILLING TO CONTINUE CRATE TRAINING?*

WHERE WILL YOUR DOG SPEND THE DAY?*

WHERE WILL YOUR DOG SLEEP AT NIGHT?*

WHERE WILL YOUR DOG BE KEPT WHEN YOU ARE NOT AT HOME?*

IF A BEHAVIORAL ISSUE ARISES WITH YOUR DOG, HOW WOULD YOU HANDLE IT?*

HAVE YOU FOSTERED OR ADOPTED FROM ANOTHER RESCUE BEFORE? IF YES, PROVIDE RESCUE NAME AND CONTACT.*

HAVE YOU OWNED PETS IN THE PAST 3 YEARS BUT NO LONGER HAVE THEM?*

YESNO

IF YES, WHAT HAPPENED TO THEM?

WHAT ANIMALS DO YOU OWN NOW? (Please include animal type, gender, age. ALSO INCLUDE TEMPERMENT ABOUT EACH PET)*

ARE THEY SPAYED OR NEUTERED? If no current animals, please select N/A.*

YESNON/A

IF NO, PLEASE EXPLAIN:

ARE YOUR CURRENT DOGS OR CATS UP TO DATE ON VACCINATIONS AND RABIES? If no current animals, please select N/A.*

YESNON/A

ARE YOUR CURRENT DOGS OR CATS CURRENT ON HEART WORM AND FLEA/TICK PREVENTATIVES? If no current animals, please select N/A.*

YESNON/A

WHAT TYPE OF HEART WORM PREVENTATIVE DO YOU USE?

WHAT TYPE OF FLEA/TICK PREVENTATIVE DO YOU USE?

WHAT IS THE NAME & PHONE # OF YOUR CURRENT VETERINARIAN?*

ARE YOU FINANCIALLY PREPARED TO PROVIDE THE NECESSARY CARE FOR YOUR PET: INCLUDING PROPER FOOD, VACCINATIONS, PARASITE CONTROL (FLEAS, TICKS, WORMS, ETC.) ADEQUATE SHELTER, AND VETERINARY CARE FOR YEARLY CHECK-UPS AND MEDICAL EMERGENCIES?*

YESNO

HAVE YOU EVER SURRENDERED A PET TO AN ANIMAL SHELTER OR RESCUE?*

YESNO

IF YES, WHAT WAS THE REASON?

HAVE YOU EVER RE-HOMED YOUR PET?*

YESNO

IF YES, PLEASE EXPLAIN THE CIRCUMSTANCES

ARE YOU AWARE AND UNDERSTAND BULLY UP'S ADOPTION FEE IS NON-REFUNDABLE?*

YESNO

The adoption donation for a Bully Up Rescue companion is due in full at the time of the adoption, after the trial foster to adopt (FTA) period is completed.

Adoption Donation:

$300 Adults 1 year of age or older

$400 Puppies

More information about the FTA process is below. Please know the adoption donation is non-negotiable and non-refundable. The adoption donation made by you helps defray the cost of spay/neuter, vet care, vaccinations, food, supplies, etc., and allows our rescue to continue to save other dogs in need.

IF YOU HAVE ANY ADDITIONAL INFORMATION YOU WOULD LIKE TO PROVIDE, PLEASE ADD BELOW.

IMPORTANT - PLEASE READ: ADOPTION APPLICATION AGREEMENT

By typing/signing your name below, you acknowledge that you have read the above information carefully and have filled out this application honestly. You understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. If an omission or untruth is discovered after the dog transitions into your home, you understand that Bully Up Rescue reserves the right to annul this application and remove the dog from your home. You also give Bully Up Rescue permission to fully investigate the information provided and confirm what has been submitted on the application, email, or disclosed verbally. If the application passes this review, you agree to a home and yard visit on a mutually agreed upon date before the dog transitions into your home/an adoption decision is made. In addition, you understand the adoption decision is dependent on many factors, including but not limited to, the compatibility of you, your family and home to the individual dog/companion.

Foster-to-Adopt

Once the application is 1) approved and verified; 2) you have conducted a meet and greet with our dog and wish to move forward, and 3) your home check is successful; Bully Up Rescue offers a 7-14 day “foster to adopt” (FTA) trial period. Our rescue offers the FTA to ensure the dog is a good fit for your home prior to finalizing the adoption. During the FTA trial period, our rescue maintains ownership over the dog and provides all needs for the transition into your home. This includes, but is not limited to the following: medical, food, crate, bowls, leash, collar, treats, flea/tick/heart worm preventatives etc. Prior to the dog transitioning to your home for the FTA period, our rescue will provide specific instructions to help make the dog’s transition into your home successful. You agree to follow these instructions provided by Bully Up Rescue directors or volunteers.

You agree that you have at least a basic understanding of handling dogs. You also understand that dogs may bite, scratch, or otherwise cause you or others in your home harm, even if the dog is observed to have a good temperament. You understand that dogs, especially ones that have been rescued and possibly abused and/or traumatized, can get easily startled, scared, feel threatened and could potentially cause harm to you or others in your home. You expressly assume the risk of all injuries or damages you might incur during the FTA trial period with Bully Up Rescue. You understand that Bully Up Rescue obtains dogs that are strays, from shelters, or from a third party. Therefore, all information regarding its age, breed, health status and/or temperament is estimated, and not warranted or guaranteed by Bully Up Rescue. During the FTA period, you agree to keep the dog as an indoor pet, treat it humanely, and notify Bully Up Rescue immediately if any behavioral or medical concerns arise. You agree and understand that Bully Up Rescue makes all medical decisions regarding the dog during the FTA trial period. You agree that if you are no longer able to keep the dog for the FTA trial period, you will provide Bully Up Rescue at least 48 hours to obtain another foster placement. You further agree that if any behavioral issues occur in the home with your personal dog, you will notify Bully Up Rescue immediately and you will not bring or surrender the Bully Up dog to animal control or give to a third party.

Once the FTA trial period is complete and you wished to adopt the companion, we will provide you with the adoption agreement and at that time, the adoption donation would be due. This donation ensures your new companion is fully vetted and defrays the cost of the spay or neuter, vaccinations, rabies, microchip, food, and flea/tick/heart worm preventatives for the transition into your home.

Adoption

Adopting a Bully Up companion is a 10-15 year commitment. In your decision to adopt a new companion, please ensure you take into consideration the life long expenses for maintaining a healthy dog to include annual vet visits for vaccinations, unexpected vet visits for medical attention, cost of flea/tick/heartworm preventatives, food, and training needs, if necessary. By typing your name below, you acknowledge this commitment and are 100% dedicated to potentially adopting/caring for a Bully Up companion.

BY TYPING YOUR FULL NAME BELOW, YOU AFFIRM THAT ALL INFORMATION PROVIDED BY YOU IN THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF YOUR KNOWLEDGE. IN ADDITION, YOU UNDERSTAND THE ADOPTION APPLICATION AGREEMENT STATED ABOVE AND AGREE TO COMPLY WITH IT. *

TYPE FULL NAME HERE

Date*

Date

Bully Up Rescue Adoption Application