Pit bull/Dog Adoption Application

Dog of Interest

Name, description or preferences

Would you considered adopting from your local animal shelter?

Applicant's Legal Name

First and Last Name

Street Address (Address, City, State & Postal/Zip Code)

Address where Dog will reside

Mailing Address (Address, City, State & Postal/Zip Code)

If different from above street address

Phone Number

Area CodePhone Number

Applicant's Email

Home Information (What type of home will the dog live in?)

Home Ownership Information

Other

Home Owner/Landlord's Name (If you are not the Home Owner)

Home Owner/ Landlord's Phone an/or E-mail (If you are not the Home Owner)

The Home has the following (Please select all that apply):

If there is no fenced yard how will you exercise the dog?

If the yard is not fenced who will walk the dog and how often will you take the dog out?

Name & Age (Self)

Name, Age & Relationship

If child; Name is not required

Name, Age & Relationship

If child; Name is not required

Name, Age & Relationship

If child; Name is not required

List additional household members below (Name, Age & Relationship)

If child; Name is not required

Did your entire family agree on the adoption of this one dog?

Will the whole family share in the care of this dog?

Is there any member of your household who is allergic to dogs?

Are there any children that visit your home frequently?

Ages (if applicable)

Do you want this dog to be:

Where will the dog be kept during the day?

Where will the dog be kept at night?

Where will the dog be kept when you are not home?

How many hours during the average day will your dog be without a human?

Are you planning to move within the next 6 months?

What will happen to the dog if you move unexpectedly?

What will you do if your new dog doesn't like other dogs?

What will happen to the dog if your new residence doesn't allow pets/pit bulls?

What will happen to the dog if you go on vacation or in case of an emergency?

Emergency Contact Information

Emergency Contact Name and Phone

What type of vehicle do you own?

If you have a truck how will your dog be transported?

Please tell us why you would like to adopt a dog:

Do you have any other pets living with you now?

Pet #1 (Dog, Cat, Bird, Etc)

Breed

Sex & Spayed/Neutered

Age

Pet #2 (Dog, Cat, Bird, Etc)

Breed

Sex & Spayed/Neutered

Age

Pet #3 (Dog, Cat, Bird, Etc)

Breed

Sex & Spayed/Neutered

Age

List additional pets below (Breed, Sex/Spayed or Neutered & Age)

Have you owned pets in the past?

List Past Pets below (Type/Dog, Cat, Bird, Etc & Breed)

Where are your Past Pets now?

Veterinary Name or Office

Veterinary Phone and/or Email Address

How often do you feel a dog should see a veterinarian?

Do you feel you are financially capable of paying for routine veterinary care?

What will you feed your new dog?

What kind of behavior do you find unacceptable?

If the dog has problems with behavior what will you do about it?

Would you euthanize a dog for Aggression towards other animals (dogs, cats, livestock)

Other

Are you currently on probation or parole?

If you are currently or will be on probation or parole, please list the officer's name and phone number and describe the circumstances below:

Please check with your officer to ensure you are permitted dogs/pit bulls.

Additional Information for consideration (if any)

Reference #1 Name:

Reference #1 Phone:

Reference #1 Relationship to Applicant:

Reference #2 Name:

Reference #2 Phone:

Reference #2 Relationship to Applicant:

Reference #3 Name:

Reference #3 Phone:

Reference #3 Relationship to Applicant:

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✔I/We hereby agree to care for this dog humanely, (including providing adequate food, water, shelter and attention).,

✔I/We agree that said dog shall be maintained in an adequate enclosed area or on leash at all times. Dog shall not be allowed to roam at will.,

✔I/We agree to have dog neutered/spayed (if applicable).,

✔I/We agree to have dog vaccinated annually with necessary inoculations (DHLP-P) and vaccinated against Rabies, as local ordinances requires.,

✔I/We agree to provide essential veterinary care, as needed.,

✔If said dog becomes lost or stolen, I/We agree to notify the "seller" or Wyoming Pit Bull Post, Inc.immediately.,

✔If, at any time, I/We are unable or unwilling to care for this dog, I/We agree to contact and return said dog to the "seller" or a representative.,

✔I/We also agree not to sell, trade, dispose of or euthanize said dog (unless recommended by a veterinarian in the best interest of said dog),

✔I/We acknowledge that the adoption fee (if applicable) will not be refunded.

✔I/We agree that said dog shall not be used for medical or any other experimental purposes.,

✔I/We agree that said dog will not be sold or given to a pet store, supplier or wholesaler.,

✔I/We agree that said dog will not be used for any illegal purposes.,

✔I/We agree that said dog will NEVER be fought in any way.,

✔I/We certify that we do not live in a home or area where "Pit Bulls" are banned.,

✔I/We agree to notify the "seller" or Wyoming Pit Bull Post, Inc. within 10 days of any change of address or phone number.,

✔I/We understand that the "seller" or Wyoming Pit Bull Post, Inc.makes no guarantees or warranties regarding the health or temperament of this dog.

Acknowledgment of Applicant/Signer

By signing below, I warrant the truthfulness of the information provided & certify that all information is true. I understand that false information may result in nullifying this adoption at any time. Electronic Signature

Type Legal Name:

Date:

Pit bull/Dog Adoption Application & Contract

Applicant Information

Home & Household Information

Please list below all the people your dog will be living with (including yourself):

General Care

Household Pets

Health & Behaviour

Additional Information

References

General Acknowledgement

Adoption Contract/Terms of Acceptance