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Name:
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Name of spouse or partner:
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Email Address:
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Full Mailing Address:
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Home Telephone:
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Cell:
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Work:
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Type of fencing:
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Block wall
Wood fencing
Chain link
No fenced yard
Other
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If other, please describe:
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Do you own or rent your home:
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If you rent, please provide land lord contact information:
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Do you have a pool?
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Yes
No
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Is your pool fenced?
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Yes
No
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Your Occupation:
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Name of employer:
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Occupation of spouse or significant other:
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Name of employer:
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Is some one home during the day?
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If no, how many hours a day will your pet be alone:
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Where will your pet be kept during the day?
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Where will your pet sleep at night?
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Do you have a kennel or crate?
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Will you purchase a kennel or crate?
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What will you do with your pets if you vacation?
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What type of vehicle do you drive?
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Mini Van
Sedan
Truck
Truck
with camper shell
Wagon
Box Van
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Do children live in your home, if yes please provide ages and information:
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Do your children have experience with big dogs?
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Yes
No
Not applicable
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Do any of your children have a fear or dogs or past negative experience with dogs?
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Yes
No
Not applicable
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Please describe any other individuals living in your home or frequently staying with you:
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Do you own any pets?
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If yes, please provide description, ages and breed and size:
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Name and contact information of your vet:
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Are all of your dogs and cats spayed and neutered?
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Yes
No
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Have you ever owned a bulldog before?
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Yes
No
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If yes, please describe:
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From whom or where did you purchase your dog?
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If you no longer own this dog, what happened to him or her?
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Have you currently applied with or are you working with any other rescues or shelters?
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Yes
No
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If yes, whom:
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Why do you want to adopt a dog (check all that apply):
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Companion
for family
Companion for other pets
Protection, presence and bark alone will scare bad guys off
Guard dog, will swiftly attack an intruder and be aggressive
As a gift
Service
dog work
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The pet you are looking for is (check all that apply):
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Perfect, practically a stuffed animal
Well behaved, obedient, needs no work
Generally well mannered, but needs some minor help
A good dog, but craves direction and needs some basic manners
Wild child, you are excited at the prospect of shaping this pet
Difficult, you are truly invested in helping a true rescue get a
chance at a good life
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Are you looking for:
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Male
Female
Either
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What age are you considering (check all that apply):
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Puppy
Young Adult
Adult
Senior
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Would you consider a special needs pet?
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Yes
No
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Can you work with a timid or shy dog?
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Yes
No
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Can you handle a strong or dominant dog?
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Yes
No
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Will you work on house training with a pet if necessary?
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Yes
No
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Will you work on basic obedience with a pet?
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Yes
No
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Will you attend obedience classes with your pet if necessary?
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Yes
No
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Are you looking for (check all that apply):
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Bulldog
Mix
Other
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If other, please describe:
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How far are you willing to travel to adopt a pet?
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50 miles or less
100 miles or
less
200 miles or
less
Any
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Do you understand we are a volunteer operated non profit organization and as such caring for the pets is our first
priority and you may need to be patient, our pets are in foster homes, we require you come and meet them in their foster spots
prior to adoption, we do not hold pets, we do not adopt pets into outside only homes, all of our animals are altered and vetted
before placement, and we only accept cash or money orders for adoption fees?
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Yes
No
I don't
get it
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Do you understand a volunteer or foster parent will contact you about your application as soon as we have an available
pet that matches your application:
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Yes
No
Still don't
get it
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