| Peaceful Pit Bull Humane Society Adoption Application |
| Thank you for applying to adopt with us. We are looking forward to one of our dog children finding their wonderful forever home with you. |
| 1. |
Lastname, First Name
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| 2. |
Age
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| 3. |
Lastname, First name of Spouse/Partner/Roommate
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| 4. |
Age of Spouse/Partner/Roommate
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| 5. |
Email:
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| 6. |
Phone
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| 7. |
Your current Address/City/State/Zip Code. Is there a chance that you will be moving soon?
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| 8. |
Driver's License #
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| 9. |
Name and Address of current Employer
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| 10. |
Working Hours
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| 11. |
Your veterinarian. If you have more than one please list all as following: Name/ Address/City/State/Zip/Phone
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| 12. |
Please list 2 personal references and their relationship to you, at least one not being your family member. List as following: Name/Relationship/Phone/ Address
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| 13. |
Why did you decide that you want to add a new family member to your family? When was this decision made? Was it a family decision or solely yours?
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| 14. |
Why are you looking to adopt an American Pit Bull Terrier or American Pit Bull Terrier Mix?
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| 15. |
Is everyone living in your household aware of the decision to adopt an American Pit Bull Terrier?
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| 16. |
Who will be the person responsible for the daily care of the dog such as feeding and exercise? Pleast list name.
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| 17. |
Please describe what you are looking for in your future pet. This can include Age/Sex/Reason for sex preference/Size/Coloring/Temperament
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| 18. |
Will you accept an American Pit Bull Terrier / Mix with special needs?
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| 19. |
Is there a dog in our program that you are interested in? If yes, which one and why?
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| 20. |
How will your new dog spend the days? Please check all that apply.
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| 21. |
How will your new dog spend the nights? Please check all that apply.
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| 22. |
Have you owned an American Pit Bull Terrier / Mix before? If yes, what happened?
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| 23. |
Do you currently have pets? If yes, please list following: Species / Breed /Age /Sex/Are they Spayed/Neutered / Are they current on vaccines / Are they current on their Rabies shot
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| 24. |
Have you owned any pets in the last 10 years? Please list as following: Species/Breed/Sex/What happened to them?
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| 25. |
Where did you get your pets from? (e.g., breeder, store, shelter, etc.) If you have ever adopted from a shelter/rescue in the past which organization did you adopt from?
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| 26. |
Did you ever give a dog up for adoption, to a shelter, a rescue, a friend or family member? If yes, when, to who and why?
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| 27. |
Have you ever had to euthanize a pet? If yes, why?
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| 28. |
Do your dogs have any physical or behavioral problems? If yes, please shortly explain.
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| 29. |
Do your dogs have any dominance problems? Any toy or food aggression? If yes, please shortly explain.
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| 30. |
Do your dogs get along with other dogs of both sex? Do they get along with other animals besides dogs?
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| 31. |
Do you have children? Please list as following: Name/Age
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| 32. |
Have they had dogs? Was it successful? If yes, what did you do to ensure the success of the kid & pet relationship?
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| 33. |
If you do not have any children yet, are you planning on having children in the future? If yes, what consequences will this have for your dogs?
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| 34. |
How many adults live in your home. Adults are considered everyone over 18. Please list as following: Name/Age
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| 35. |
Which one of the following do you live in?
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| 36. |
Are you residing in a town/city that currently has BSL?
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| 37. |
Are there any community restrictions on dogs (if so, explain)?
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| 38. |
Type of residence:
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| 39. |
Do you own or rent your home?
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| 40. |
What is your yard size? Is it fenced? What is the fence height?
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| 41. |
If you are renting, do you have your Landlord’s permission to foster a dog?
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| 42. |
Please list your Landlord’s Name/Phone/Address/City/Zip Code
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| 43. |
Is there any chance you might move in the next 10 years? If yes, are you willing to restrict your choice of housing to places where an American Pit Bull Terrier is allowed? Do you understand that finding rental housing with an American Pit Bull Terrier can be extremely difficult and time consuming?
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| 44. |
Is someone home during the day?
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| 45. |
Do you have a petsitter or someone that comes and walks your dogs while you are at work or running errands? If yes, please list name and phone number.
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| 46. |
Who will care for your pet when you are not at home/travel? How do you plan on handling this with your foster pet? Please List name and number of person, boarding facility, etc.
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| 47. |
Do you understand that that a new dog will take time to adjust to its new surroundings and that certain behavioral issues might occur?
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| 48. |
Are you willing to work with your new dog to correct these issues
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| 49. |
How do you enforce basic obedience training such as sit, stay, lay or even potty training? Do you believe in punishing your dog to discipline it? Please explain your methods of punishment:
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| 50. |
How do you enforce basic obedience training such as sit, stay, lay or even potty training? Do you believe in punishing your dog to discipline it? Please explain your methods and punishment:
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| 51. |
Describe your experience with dogs and what educational experience you have had with dogs. Be specific (i.e. training classes, books, volunteering etc.)
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| 52. |
Any other information that may be helpful for us to know when reviewing your application?
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| 53. |
Do you agree to allow us to visit your home by appointment as part of our application process?
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| 54. |
Hereby you certify that all of the information you have provided in this application is true and correct. If any of the information changes, you will contact Peaceful Pit Bull Humane Society promptly. Application Date and Signature
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| 55. |
Signature of Spouse/Partner/Roommate
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