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BCAC Adoption Application
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* Indicates required question
Email
*
Your email
Option 1
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Your Name
*
Your answer
Option 1
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Physical Address - NO PO Box`s
*
Your answer
City,State and Zip
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Your answer
Home Phone
*
Your answer
Work Phone
Your answer
Place Of Employment
Your answer
Employer Address
Your answer
Active Duty Military
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Yes
No
Applying for Dog or Cat
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Dog
Cat
Name of Pet interested in:
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Your answer
Do you want this pet for:
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Companionship
Protection
Gift
This pet will be without human companionship for:
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4 to 6 hours a day
6 to 8 hours a day
Other:
Please provide the following info about your household: Number of adults and ages
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Your answer
Please provide the following info about your household: Number of Children and ages
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Your answer
Who will be responsible for the pets care?
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Your answer
You live in a :
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House
Farm
Apartment
Mobil home
Condo
Other:
Do you:
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Own
Rent
Live with parents
Other:
Do you have fenced yard?
Yes
No
Other:
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Type of fence and height
Your answer
Landlord Name and Phone Number:
Your answer
Does your landlord have a size or breed restriction? If so, please explain below.
Yes
No
Maybe
Other:
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What are your breed and size restrictions?
Your answer
List all pets you currently own and if they are fixed or not fixed, please. If none, put 0.
*
Your answer
Do you realize it may take a new pet 2 or more weeks to adjust to a new home, Especially if other pets are involved?
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Yes
No
Have you ever given up a pet? if so why?
Your answer
List veterinarian contact info:
Your answer
(Dog) What type of heartworm preventative do you use currently or in the past?
Your answer
Where will this pet be kept during the day?
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Your answer
Where will this pet be kept during the night?
*
Your answer
For Cat Adoption
Is your cat going to be an indoor only cat?
Yes
No
Maybe
Clear selection
Are you planning on declawing your cat?
Yes
No
Maybe
Clear selection
Are you aware that a declawed cat must be kept inside?
Yes
No
Maybe
Clear selection
What will you do with your pets if you move in the future?
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Your answer
Have you adopted from us before?
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Yes
No
Maybe
Have you ever been rejected? If so, why?
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Your answer
By sending this electronically, I acknowledge that i have read this and comprehend it fully?
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I agree
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