Test

    Applicants Information

    Applicant's Full Name*
    DL or ID Number*
    DL or ID Expiration Date*
    Date of Birth*
    Cell Phone*
    Email*
    Address*
    City*
    State*
    Zip Code*

    Co-Applicant Information

    Are you applying with another person? YesNo

    Co-Applicant Name
    Dl or ID Number Expiration Date
    Date of Birth
    Cell Phone
    Email
    Relationship to Applicant

    Number of Adults in Household

    Relationship of other adults in household
    Please list the name and phone number of other adults.

    Are all applicants currently employed? YesNo
    Current place of employment
    Number of (two-legged) children in household

    Please list the ages of children in household:

    Does anyone in your household have allergies to dogs? YesNo
    Is anyone home during the day? YesNo

    How many hours would the dog be left unattended?

    Where will your dog be kept during the day?
    Where will your dog sleep at night?
    How will you provide for a dog if you are to go out of town?
    If you plan to board your pet(s), what boarding facility do you plan to use?
    Do you plan on moving in the foreseeable future? YesNoUnsure
    If you ever do move, what would you do with your pet?
    What type of residence do you live in?
    Do you rent or own*?

    Does your lease allow pit-bull or pit-bull type dogs? YesNo
    Name of landlord
    Phone Number of landlord

    Current Pet Care Experience

    Are you a first time dog owner*? YesNo

    Number of dogs currently owned
    Please list the names, ages, breeds, and sexes of dogs currently owned

    Do you have other pets?* YesNo

    Number of other pet(s)
    Please list the names, ages, breeds, and sexes of other pet(s):

    Are all current pets spayed/neutered? YesNo
    If no, please explain.

    Are they on heartworm/flea/tick preventative? YesNo
    Are they current on rabies, DHPP, and Bordetella? YesNo
    If no, please explain.

    Who is your veterinarian for your current dogs?
    Name
    Address
    Phone Number
    What name(s) are your pet(s) listed under at your vet?

    Previous Pet Care Experience

    This refers to pets that you have been responsible for.
    Please provide information on all previous pets within the past 5 years.
    Please list the names, ages, breeds, and sexes of previous pets.

    How long did you have this/these pet(s)?
    Where are the pet(s) now?
    Have you ever had to euthanize your family pet? YesNo
    If so, why and how was your pet euthanized?

    Have you ever had to give up a pet? YesNo
    If yes, please describe the reason.

    Please provide veterinarian contact information for your previous dog(s).
    Name
    Address
    Phone Number

    Adoption Information

    Many of the dogs we adopt out have only had basic training and sometimes no formal training. If necessary, would you be willing to seek professional help to train your dog? YesNo
    Do all applicants have experience and knowledge with bully breeds in general? YesNo
    If so, how many years of experience do you have?
    If you do not have experience, are you willing to in our training program? YesNo
    Which of the following behaviors or characteristics/issues would you be willing to work on with your dog? (Please select all that apply)
    House trainingFearfulnessBarking/whiningSeparation anxietyChewingDiggingMouthing/playing roughPulling on leashWary of strangersJumping on furnitureAggressionBasic obedience issuesAll of the aboveI am not willing to work on any issues
    How will you resolve those problems?
    Have you ever worked with a rescue organization? YesNo
    If yes, which one(s)?

    It may take your pet a month or more to adjust to a new home. Are you willing to allow this much time for adjustment? YesNo
    Dogs often live 10-15 years. Are you prepared to make this commitment? YesNo
    The estimated yearly cost of caring for a dog is $1,500. Can you afford the financial cost of owning this dog? YesNo
    I would consider providing a stable environment to this kind of dog:
    playful/curiousactive/athletic (running partner)moderately active (daily walks)quiet (some walking, laid back, more couch time)no barkingaggressivedog friendlycat friendlypeople friendlykid friendly (ages 12 and under)needs socializingspecial needspair (siblings/found together/etc.)puppy (6 months or under)young (6 months to 2 years)adult (2-6 years)senior (7 years and up)
    What kind of dog are you looking for?
    house dogfighting dogchildren’s dogoutside dogcompanion for your current doghunting dogpersonal companionservice dogguard dog- to protect your home or business
    How do you plan to exercise your dog on a daily/weekly basis?
    walkingjogging/runningindoor threadmilldog parkobedience trainingplaytime in your backyarddog daycareother:

    Reason my family and I consider valid for giving up a dog:
    movinglost of employmentchange of work scheduledestructive (digging/chewing)bitting/nippinggrown to largeallergiescost of up keepnot housetrainedtoo rough with childrenbarking too much or too littleexpecting/having a babydog has health issuesnoneother:

    Reason my family and I consider a valid reason(s) for humanly euthanizing our dog:
    fighting/attacking other animalshuman aggression (full blown attack)bitting/nipping (no aggression)not having time for the dogallergies/causing health issues to my familyillness that is treatable/curable, but can’t afford itterminal illnessdog is too old and family wants a puppymoving and cant take dogdog has behavioral issues and needs training but can’t afford ittoo destructiveother:

    What Brave Bully Rescue dog are you applying for?

    I’m particularly interested in (name of dog)
    Where did you see this dog?
    If the dog you are interested in turns out to not be a good match for your family, or your family a good match for he/she, will you be willing to consider another bully in our rescue? YesNo
    How did you hear about Brave Bully Rescue?

    Please list 3 References that are not family related

    Reference 1

    Full Name*
    Address
    Phone Number*
    Relationship
    Years of Relationship*

    Reference 2

    Full Name*
    Address
    Phone Number*
    Relationship*
    Years of Relationship*

    Reference 3

    Full Name*
    Address
    Phone Number*
    Relationship*
    Years of Relationship*

    Please read carefully.

    • Dog care can be costly and can average $1,500.00 or more annually. This includes annual vet care, parasite testing, monthly heart worm & flea preventative, dog food, miscellaneous equipment, boarding/kennel fees, grooming and other supplies. This does not include any injuries, nor illnesses the dog may incur. I understand that any bodily injury or property damage incurred from a rescue is my responsibility, and that I will not hold Brave Bully Rescue or any of its members responsible or liable. I agree to indemnify and hold harmless brave bully rescue, its agents, volunteers and staff from any and all claims, lawsuits, injuries, or damages.
    • I understand that if I adopt a dog over the age of 1 year old I will pay an adoption fee of $250.00. If I am adopting a dog under the age of 1 I will pay an adoption fee of $300. For puppies there is a non- refundable deposit of $100.00 that will apply to the neuter/spay and vetting. Once the adoption is finalized, the $100.00 deposit will apply to the $300.00 adoption fee. The adoption fee is non-refundable upon signing the adoption contract. I understand I am not allowed to gift, surrender to a shelter, sell or adopt out a dog in my care to anyone else without the consent and approval of Brave Bully Rescue.
    • By signing below, I certify that the information provided on this application is true and I recognize that any misrepresentation of facts may result in losing adoption/foster privileges. I authorize investigation of all statements in this application and understand that a background check will be performed, including, veterinarians, landlords, and other humane agencies, etc. May be contacted. I further understand that submitting an adoption application does not mean that I am approved for adoption.
    • I understand the adoption of this pet may be delayed until all information can be verified. Incomplete applications will not be processed and can be subject to rejection. Please print below your first and last name as your signature to indicate your acceptance of the above terms. By signing this application indicates your agreement to be bound by the above terms.

    Signature

    Please prove you are human by selecting the Key.