Ariel Bully Rescue
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Dog Adoption Application and Contract
Dog Interested In:
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Date of Application:
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Breed:
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Gender
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Applicant(s) Name:
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Address
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City
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State
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Zip
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Place of Employment:
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Since (mo/yr)
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Email:
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Home/Cell Phone:
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Work Phone:
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1. Please describe the temperament, activity level, and special qualities you are looking for in a dog
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2. What do you think are the most important responsibilities in owning a dog?
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3. Are you willing to take the time to housebreak a dog, and do you understand that changing a dog's environment may cause the dog to have accidents?
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Yes
No
4. If a behavioral problem arises, what steps will you address it?
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5. If you are applying for a puppy/dog who is not housetrained, how will you housetrain the dog:
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6. Does any member of the family have any allergies to animals? (Yes or No) Explain:
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7. Describe the kinds of personal situations where you might have to return your adopted dog, i.e., job loss, children, move, marital change, etc.
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8. For whom are you adopting the dog?
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Self
Gift
Other family member
9. How many people live in your home?
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10. Are there any children in the household? (Yes or Now) If yes, what are their ages?
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11. Who will be responsible for feeding and taking the dog outside?
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12. Who will take care of the dog in the absence of the primary caretaker?
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13. Do you plan taking the dog to obedience school?
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14. What kinds of animals have you owned?
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15. Describe pets you currently own or have owned in the past. Include age, sex, breed, and temperament:
Pet number 1:
Name
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Breed
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Age
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Sex
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Is the pet Spayed or Neutered?
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Yes
No
Primarily Indoor or Outdoor? Explain:
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How did you acquire the animal?
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Has the pet been Spayed or Neutered?
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Yes
No
Year deceased (or last year you had pet)?
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Cause of death, or where pet is now :
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Pet number 2:
Name
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Breed
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Age
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Is the pet Spayed or Neutered?
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Yes
No
Primarily Indoor or Outdoor? Explain:
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How did you acquire the animal?
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Has the pet been Spayed or Neutered?
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Yes
No
Year deceased (or last year you had pet)?
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Cause of death, or where pet is now:
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Pet number 3:
Name
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Breed
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Age
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Sex
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Is the pet Spayed or Neutered?
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Yes
No
Primarily Indoor or Outdoor? Explain:
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How did you acquire the animal?
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Has the pet been Spayed or Neutered?
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Yes
No
Year deceased (or last year you had pet)?
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Cause of death, or where pet is now:
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Pet number 4:
Name
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Breed
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Age
*
Sex
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Is the pet Spayed or Neutered?
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Yes
No
Primarily Indoor or Outdoor? Explain:
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How did you acquire the animal?
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Has the pet been Spayed or Neutered?
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Yes
No
Year deceased (or last year you had pet)?
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Cause of death, or where pet is now:
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16. Have you considered the extra expenses that will come with having a dog including vet care, food, supplies and equipment, toys, training and boarding?
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17. What type of home do you live in?
House
Townhouse
Duplex
Condo
Apartment
Mobile
18. Do you own or rent your residence?
Own
Rent
19. If you rent:
Landlord Name
Landlord Phone Number
20. What type/size pets are allowed? How many?
21. Do you have a fenced yard?
Yes
No
Height of fence at lowest point?
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Highest point?
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Note: Secure, fully fenced yards are typically required for homes. For some dogs, fences of minimum 5 to 6 ft are required.
22. Any holes or gaps?
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Yes
No
23. Is the fence attached to the home?
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Yes
No
24. Do you understand the risks of dog parks? (dog fights, dog owners not paying attention while dogs unleashed).
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25. How many hours will the dog be left unattended (i.e., workday)?
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26. When you are home, where will the dog be kept?
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27. Where will the dog sleep at night?
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28. When no one is home (i.e. at work, shopping), where will the dog stay (be specific)?
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29. What will you do with the dog when you travel?
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30. If you move, what will you do with the dog?
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31. Are you aware of the adoption fee (non-refundable donation)?
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Yes
No
32. Are you familiar with your local animal control laws?
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Yes
No
33. Have all adult family members agreed upon the dog?
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Yes
No
34. If you decided that is dog is not the right dog for you, then you will return the dog to: Ariel Bully Rescue?
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Yes
No
35. Do you have experience with bully breeds? If so, please explain:
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Personal Reference 1:
Personal Reference (someone who can attest to your character):
Name:
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Phone:
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Number of years you have known one another:
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Personal Reference 2:
Personal Reference (someone who can attest to your character):
Name:
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Phone:
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Number of years you have known one another:
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Personal Reference 3:
Personal Reference (someone who can attest to your character):
Name:
*
Phone:
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Number of years you have known one another:
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Veterinary Reference (someone who can attest to your pet being well kept):
Name:
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Phone:
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Reference Check: by signing this application you agree to allow us to contact the veterinarian and personal references listed on this application
By printing and signing your legal name in the space below, you are certifying that you have read and understand all of the above information. That the information you provided is true and correct and that you are the person completing this application.
Signature of Applicant
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Print name
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Date
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Email
Submit
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