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Dog Adoption Application
Buy, Sell, Rescue, Inc.
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* Indicates required question
Email
*
Your email
Full name (First & Last)
*
Your answer
Full address
*
Your answer
Phone Number (xxx-xxx-xxxx)
*
Your answer
Identification Number or Drivers License
Your answer
Name of pet you are applying for:
*
Your answer
Please indicate the reasons for adopting this pet:
*
Companion
Watch/Guard Dog
Gift
Family pet
Other:
Required
Do you live in a:
*
House
Apartment
Condo
Mobile Home
Do you:
*
Own
Rent
If you rent, please provide your Landlord's' Leasing Office name and phone number
Your answer
Does your lease/property permit you to have pets?
*
Yes
No
How long have you lived at your residence?
*
Your answer
Does your lease/property have pet restrictions? If yes, please elaborate:
Your answer
Do you have a securely fenced yard?
*
Yes
No
Number of
adults
living in your residence &
ages
:
*
Your answer
Number of
children
living in your residence &
ages:
*
Your answer
Are all your animals spayed/neutered?
*
Yes
No
If they are
not
spayed/neutered, why?
Your answer
Is everyone in your household aware and approve of this adoption?
Yes
No
Clear selection
Who is responsible for the daily care & feeding of this animal?
*
Your answer
Is anyone in your household allergic to dogs?
*
Yes
No
Unsure or unknown
Is anyone home during the day?
*
Yes
No
Sometimes
Where will your pet be kept during the day?
*
Indoors
Outdoors
Crated
Garage
Other:
Required
Please provide details about
where
the dog will spend their day, including whether they'll be outdoors, for
how long
, and
the environment
(e.g., "they'll have dog-door access to a secure backyard with a covered patio while I'm at work.").
*
Your answer
Where will your dog be sleeping?
*
Crate/Kennel
Outdoors
Indoors
Garage
Other:
Required
On average, how many hours per day will your dog be left alone?
*
Your answer
Please tell us why you are the best candidate for this dog?
*
Your answer
Do you have prior experience owning a dog?
Please share your experiences from the past five years, including any reasons why your previous dog is no longer with you.
*
Your answer
Under what circumstances would you feel it necessary to give this dog up?
*
Dog barks or whines too much
Dog has a potty "accident" in the house
Dog becomes aggressive
Dog becomes very ill
Dog damages property (i.e. carpet, furniture, etc.)
Dog becomes larger than anticipated
Divorce/Separation
You must relocate to another house/city/state
Nips at stranger
High vet bills
Other:
Required
What is the
name
and
phone number
of your current veterinary clinic?
*
Your answer
Are you willing to commit to a training class/program with this dog if required?
*
Yes
No
Are you aware that we often have limited information about whether a dog is housebroken, and are you prepared and capable of potty-training this dog if needed?
*
Yes
No
What are your strategies for training and disciplining this dog?
*
Your answer
How long are you willing to give this dog to bond with you and settle into his/her new home?
*
1 day
1 week
1 month
Other:
Please indicate your understanding of each term by checking the corresponding box:
*
I understand that by adopting this animal, I am committing to care for it as a member of my family for its natural lifespan, which averages around 17 years for a dog.
I am financially capable of meeting the animal's needs, including food, supplies, shelter, veterinary care, and heartworm prevention medication, which may cost up to $800 per year.
I have or will allocate sufficient time to spend with my new pet, including training, exercise, and grooming.
I understand that if I relocate, my pet will accompany me.
I acknowledge that I must adhere to all state and local regulations regarding pet licensing and vaccination schedules.
Required
By entering my name below, I certify that all information provided in this application is accurate and complete. I acknowledge that the decision to adopt a particular dog is my own. I absolve the current owner of any responsibility for any damage, injury, or harm, whether direct or indirect, caused by any dog I may choose to adopt.
Example:
[Type Your Name]
[Date]
[Time]
*
Your answer
A copy of your responses will be emailed to the address you provided.
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