Adoption Application | Bullied Breeds Rescue

Applicant First Name

Applicant Last Name

Applicant Occupation

Co-Owner First Name

Co-Owner Last Name

Co-Applicant Occupation

Phone

Email

How Many Adults (18+) Live in your Home?

How Many Children (under 18) Live in your Home?

What are the Ages of the Children in the Home?

If you do not own your home, please provide your landlords name and phone number:

Please List All Dogs/Cats in your Home (Name, Age, Sex, Breed):

Please List All Past Dogs (name, age, sex, breed):

How Long Each Day are you Outside of the House (when the dog would be left home alone):

Please Describe 'Other' Training you plan to use (if applicable):

Please Describe any Experience you Have with Training Dogs or Dealing with Behavioral Issues:

Is there a Training Facility/Person you Currently use or Plan to use?

Why are you Interested in this Particular Breed? What do you Like about them?

Is there Any Other Information you would Like to Share about you, your home, your animals etc?

Which Dog are you Applying to Adopt?

Please Provide a Personal Reference who can Speak to your Character & their Phone Number:

Please Provide a Second Personal Reference who can Speak to your Character & their Phone Number:

Please Provide your Current Vet's Name & Phone Number (if applicable):

Have you Ever Had Anything Filed with Past Dogs and Animal Control? If so, Please Describe and Share any Relevant Background Below:

How did you Hear About Bullied Breeds Rescue?