American Bulldog Rescue - Adoption Application

Personal Information		Date: 05.10.08
Name:	Birthdate:
E-mail:
Address:	City:
State:	Zip Code:
Occupation:
Day Phone:	Evening Phone:
What dog are you interested in?

References
Please provide the contact information of a veterinarian you have used before and plan to use with your new dog? Vet references are checked.
Vet Name:		Vet Phone:
Vet records are under the name of:
Please provide 2 refences (No family members).
Name		Phone:
Relationship:
Name		Phone:
Relationship:

Please list place of employment for yourself and your spouse, if applicable:
Employer:	Address:
Phone:
Spouse's Employer:	Address:
Phone:
Household Information	Home:	Own Rent
Are you moving in the near future?	Yes No
If so please explain:

If you rent, you MUST provide your landlord's contact information for verification.
Landlord	Phone:
List below all people who currently live at this residence.
Name: Age: Relation: Name: Age: Relation: Name: Age: Relation: Name: Age: Relation:
Does anyone in your house have any allergies to dogs?		Yes No
List below any cats, dogs, etc. who currently live in your household:
Name: Breed: Age: Sex: Spayed/Neutered: How long owned: Kept where: Name: Breed: Age: Sex: Spayed/Neutered: How long owned: Kept where: Name: Breed: Age: Sex: Spayed/Neutered: How long owned: Kept where: Name: Breed: Age: Sex: Spayed/Neutered: How long owned: Kept where:

History
Have you owned a dog before? Yes No
A large breed?	Yes No	A large Bully Breed?	Yes No
If yes, please explain in detail what happened to it:

If your last dog died, please state the dog's name and date deceased:

Have you ever taken one of your pets to a shelter? Yes No

If yes, please describe the circumstances:

Do you have any previous experience in dealing with a dominant or aggressive dog?
Yes No

Care of the Dog:

Do you have a fenced area on your property? Yes No

Is the area completely fenced? Yes No

If so: The fence is ft high, and the inside area is sq ft.
What type of fencing do you have?
If you have no fence, how do you plan to have your new dog relieve/excercise itself?

How active is your lifestyle aside from work? Please explain:
Do all adults work full time?	Yes No
How many hours each day will your new dog be alone?
How many hours each day will you spend time with your new dog?

Where will your new dog be kept when it is alone?
Where will your new dog sleep?
What sort of training do you plan on providing the dog?
Are you agreeable to having a homecheck done prior to adoption?
How far are you willing to drive to meet a potential adoptee?

Donation:
We request a donation and depending on the expenses incurred in thedog's/puppy's rescue and veterinary care this could range from $300.00 to $350.00 All animals are payed/neutered prior to placement. Is this acceptable? Please realize that dogs need vet care throughout their lives, including yearly boosters, heartworm and flea/tick preventative meds, etc. If you cannot afford a donation, can you afford the appropriate vet care? please consider this before adopting. Are these terms acceptable to you?If so, please indicate by checking below: I confirm all information, and agree to the above.