Best Buddy Pet Rescue - Dog Adoption Form
• You must be 21 years or older.
• Have your landlord’s and/or parent(s) contact information/consent if you rent or live at home.
General Information
Which dog are you interested in?
Your answer
Why are you adopting this dog?
(check all that apply)
Required
Who are you adopting for?
Required
Primary Adopter's Information
First Name:
Your answer
Last Name:
Your answer
Street Address:
Your answer
City:
Your answer
State:
Your answer
Zip Code:
Your answer
Home Phone Number:
Your answer
Cell Phone Number:
Your answer
Are you over the age of 21?
Driver's License Number:
If you do not fill comfortable providing this application online, please write "Ask in Person".
Your answer
Expiration Date:
If you do not fill comfortable providing this application online, please write "Ask in Person".
MM
/
DD
/
YYYY
Email Address:
Your answer
Are you employed, retired, student, or other? Please Explain.
Your answer
If employed, please provide us with the name of your employer.
Write N/A if this does not apply to you.
Your answer
Work Phone Number:
Write N/A if this does not apply to you.
Your answer
Secondary Adopter's Information
If there is no secondary adopter for this application, please fill N/A for the required fields.
Secondary's First Name:
Your answer
Secondary's Last Name:
Your answer
Are you over the age of 21? (Secondary)
Relationship to Primary Adopter:
Your answer
Secondary's Home Phone Number:
Write N/A if this does not apply to you.
Your answer
Secondary's Cell Phone Number:
Write N/A if this does not apply to you.
Your answer
Secondary Driver's License Number:
If you do not fill comfortable providing this application online, please write "Ask in Person". Write "N/A" if this does not apply to you.
Your answer
Secondary's Expiration Date:
If you do not fill comfortable providing this application online, please write "Ask in Person". Write "N/A" if this does not apply to you.
Your answer
Secondary's Email Address:
Your answer
Household Information
What do you currently live in:
How long have you lived at your current address?
Your answer
Do you have any pet restrictions?
Do you...
If renting, please provide your landlord’s name and number:
If you do not have a landlord, please type N/A.
Your answer
How many adults are living in the household?
Your answer
Children living in the household?
Your answer
Please list the ages of any children living in the household:
If you do not have any children living in your household, please type N/A.
Your answer
Does anyone in the household have allergies?
If you do NOT live alone, do all the members in the household know you plan on adopting a pet?
What is the longest period of time the dog would be left home alone on an average day?
Your answer
Where will the dog stay when you are not home?
(check all that apply)
Required
Dog Adoption Questions
How will the dog be let out to relieve itself?
Check all that apply
Required
Are you familiar with crate training?
Are you willing to crate train?
How have you disciplined your dogs in the past? What type of action was taken?
If you haven't had to discipline in the past, how would you now?
Your answer
What will do you if this pet is destructive while left alone?
Your answer
Did you keep your dog on a heartworm preventative?
Please type N/A for this question if this doesn't apply to you.
Your answer
Pet History
As an adult have you ever owned a pet? (past and/or present)
If you answer no to this question, make sure that you answer N/A for all the rest of the questions under Pet History.
Have you filled out an application with another rescue?
If you answered yes above, were you denied?
If you answered yes to filling out an application with another rescue, can you explain the details.
Type N/A if you have not filled out an application for another rescue.
Your answer
Have you ever given your pet away to someone else or a shelter?
If you answered yes, please explain.
If you answered no, please type N/A.
Your answer
Were all your pets both past and present up to date on shots?
Name and Phone Number of veterinarian:
If your animals are no longer with you, list the one used last. If you have not had any animals in the past or present, please type N/A in the box.
Your answer
Current and Past Animals
Please list any animals you have owned in the past 5 years. All information will be verified. If you do not have any animals, please type N/A in the required fields below.
Please list the animals name, age, species, spayed/neutered, and whether that animal is still living with you or not.
Type N/A if you have not had any animals in your care in the last 5 years.Your answer
Your answer
Adopted Pet Questions
What amount of time do you think is reasonable for your dog to adjust to you and your new home?
Your answer
Under what circumstances would you not be able to keep this dog?
Please check all that apply.
Required
The minimum cost of owning a pet can be over $500 per year. Are you able to assume the financial responsibility of veterinary care and basic needs for this animal?
Some dogs require a home visit. Do you object?
If you answered yes above, please explain.
If you answered no, please type N/A.
Your answer
In case of an emergency and we can’t get a hold the primary adopter’s information, please provide us with another contact person that is not already on this application. Please write their name and phone number.
Please provide a name and phone number.
Your answer
How did you hear about this dog or our rescue?
References
You must provide two references in order for your application to be processed. If you do not provide two we will not consider your application.
First Reference Name:
Your answer
First Reference Phone Number:
Your answer
Second Reference Name:
Your answer
Second Reference Phone Number:
Your answer
Acknowledgement Statements
I/we do hereby acknowledge that any false or knowingly omitted statements on this application may constitute a rejection.
I give BBPR permission to maintain contact with me by a home visit, emails, and/or telephone calls.
I understand that this application is the property of Best Buddy Pet Rescue and has the right to deny my request to adopt.
This application can be reviewed at any time for follow up procedures and in the event information provided above is false then BBPR reserves the right to seize the animal and the adopter forfeits all fees acquired at the time of adoption (total adoption fee varies for different animals).
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