Adoption Application

the proper pit bull adoption application

* Indicates required field

First and Last Name of Applicant (Dog's Primary Care Giver) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Length of Time at Address *

Email *

Home Phone Number *

Cell Phone Number *

List Any Other Adults Living in Household (or type "N/A" if this does not apply) *

Ages of any Children Living in the Home and/or that Visit on Regular Basis (Please Include Relatives and Friends) *

List Below Any Dogs, Cats or other Animals who Currently Live in Your Household

Name *

Age *

Gender *

Spayed/Neutered? *

Breed *

Owned How Long? *

Kept Where? *

Name *

Age *

Gender *

Spayed/Neutered? *

Breed *

Owned How Long? *

Kept Where? *

Name *

Age *

Gender *

Spayed/Neutered? *

Breed *

Owned How Long? *

Kept Where? *

Are all Dogs in Your Household Current on all recommended and/or Required Vaccinations? *

Yes No

Are the Animals in your Home on a Flea/Tick Preventative? *

Yes No

Please List the Dates of the Latest Vaccinations

Rabies *

Choose One *

Option 1 Option 2 Option 3

DA2PP *

Bordatella *

Other *

Please Provide the Contact Information of a Veterinarian that You Use

Vet Name *

Vet Phone Number *

Vet Records are Under the Name of: *

household information

Home *

Type of House *

Are You Moving in the Near Future? If Yes, then Please Explain *

If You Own your Home, Please Provide the Home Insurance Carrier You Use (Many have Breed Restrictions) *

If you Rent your Home, you MUST Provide your Landlord's Contact Information for Verification (Many have Breed Restrictions)

Landlord's First and Last Name *

First

Last

Company *

Phone Number *

general questions

Are you prepared to accommodate an adoption fee, the cost of monthly preventatives, and annual vet visits (~$300 annually)? *

Yes No

What behavior traits would NOT be acceptable to you and would cause you to return a dog? *

Do you or family members have allergies? *

Yes No

adoptable dog information

Name of the Dog you are Interested in Adopting *

What is the Best Time to Contact you to Discuss your Application? *

Do you agree to a home visit should your application be approved? *

Yes No