Bull Terrier Rescue Adoption Application by 8657lW88

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									     Bull Terrier Rescue – Adoption or Foster Application
Please print clearly. Thank you for taking the time to complete the application!
Date: _______         Adopt or Foster? ______________

Applicant Name(s) & Age(s ):_____________________________________________________

Street address:__________________________________________________ _____________

City:_____________________________________ State:_____ Zip:              _____

Home Phone:______________Mobile Phone:______________Work Phone:_______________

Which phone # do you prefer we call first?_________ What time is best to reach you? _______

E-mail address:_______________________________________________________________

Why do you want a Bull Terrier? __________________________________________________

Which pets do you currently own? Please list age, sex and breed:________________________

____________________________________________________________________________

Has each been spayed or neutered? __ Yes __ No          ___ Don’t know

Is each current on vaccinations & heart worm preventative? __ Yes ___No ___Don’t know

If no, please explain____________________________________________________________

What happened to pets you no longer own?_________________________________________

____________________________________________________________________________

Have you ever lost a pet, or had a pet euthanized? ___Yes __ No        If yes, please explain:

___________________________________________________________________________
Do you think your current pets will adjust to a new pet in the house? __Yes __ No __Not sure
Any concerns or considerations?__________________________________________________

 Are you & other household members willing to take advice on how to best introduce pets and
become the Alpha leader of a bull terrier? ___ Yes ___ No ___ Not sure what this means

Are your current or past dogs obedience trained? ___ Yes ___ No

If no, please explain:___________________________________________________________

Who will train the bull terrier? _________________ What method(s) will you use to train?

___________________________________________________________________________


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Why do you want this dog? Examples: Companion / Companion for other pet / House pet
Watch Dog / Guard Dog / Hunting / Personal Protection / Other (explain)
___________________________________________________________________________

Please list each adult & child in your household who will live with the bull terrier.
(Please use comments section at end, to list more info, if needed)
Name / Age        Job Title @Work Work hours Or: Student / Not Working / Retired




If children live with or visit you, has each been taught how to behave around pets? __Yes __ No

Will an adult always supervise the child around the bull terrier? ___ Yes ___ No

Does any member of your household have an allergy to dogs?        __ Yes __ No

Is any family member afraid of dogs, or not wanting a bull terrier? __ Yes __ No
If yes, please explain _________________________________________________________

Is someone home during the day? __ Yes __No If yes, who is & what hours?
___________________________________________________________________________

How many hours each day will the dog be without human companionship?________________

Type of home: Examples- House / Apartment / Condo / Other ______________
Do you __Own ___Rent If renting, please provide your Landlord’s name and phone number:

___________________________________________________________________________

Do you have home owner association, or landlord, rules about the breed or size or weight of
dog allowed? ___Yes___ No If yes, what is stated?________________________________

___________________________________________________________________________

Do you have a copy of these rules? (we do require you show proof) __ Yes __No

Do you have a completely secure, fenced yard?   ___ Yes ____ No
What type fence material?               Height?         Gate with a lock? __Yes __ No
If no, please explain:     ____________________________________________________

Are there times the dog will be tied up? __Yes___No If yes, please explain:________________

Do you have a dog door? __ Yes__ No If yes, can it be locked?_______________________

Are there stairs inside/ outside your home?__ Yes __ No An elevator? ___Yes ____No
If yes, where & how many?_____________________________________________________

Will the dog spend any time in a garage or out building? __ Yes _ No     If yes, please explain:

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 _______________________________________________________________________
Will the dog spend any time in your yard alone? __ Yes __No If yes, please explain:

________________________________________________________________________
Do you have a pool? __ Yes __ No If yes, is there a fence around the pool? __ Yes __ No

If your new dog/puppy is not yet housetrained, what method will you use to train it?
 _______________________________________________________________________

Are you able & willing to exercise the dog several times a day? __Yes __ No
Method: _______________________________________________________________

Where will the dog be kept during the day? ____________________________________

Where will the dog sleep, be kept at night? _____________________                    ______

Are you willing to use a crate?__Yes __No If no, please explain: ___________________

If you drive a pickup truck, would you allow the dog to ride in the truck bed? __ Yes __ No

If you go away for a few days, or on a vacation, who will take care of the dog?
________________________________________________________________________

Have you ever applied to a Bull Terrier Rescue Group before to adopt/ foster? __ Yes __ No
If yes, please list whom you contacted & timeframe:
_________________________________________________________________________

Are you willing to have a Bull Terrier rescue representative conduct a home visit with all family
members & pets? __Yes __ No If no, please explain: ________________________________

____________________________________________________________________________

Are you willing to take responsibility for this dog for the next 10 to 15 years? __ Yes __ No
If no, please explain:
      _____________________________________________________________________

Are you willing to purchase & use monthly heartworm preventative and flea/tick prevention for
the bull terrier? __ Yes __ No __Not sure    If no or not sure, please explain:

____________________________________________________________________________

Are you financially able to pay for annual vet visits, other vet visits & medicine, if needed?
__ Yes __No __ Not sure              If no or not sure, please explain:

____________________________________________________________________________

What provisions will you make for the dog, should you become unable to care for him/her?
____________________________________________________________________________



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Additional comments or information you may wish to share?
____________________________________________________________________________
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Name of veterinarian for current or past pets:________________________________________
Address: ___________________________________________________________________
Phone: __________________________________________________

Please provide 2-3 personal references (not family) and their contact information:

Reference #1: Name: ____________                  ___Relationship: _________________
Address: _________________           ___________________________________________
Telephone: ________________________________________________________________
About how long have you known this person? ________________

Reference #2: Name: ____________                  __Relationship:__________________
Address: _________________           ___________________________________________
Telephone: ________________________________________________________________
About how long have you known this person? ________________

Reference #3: Name: ____________                  ___Relationship:_________________
Address: _________________           __________________________________________
Telephone: _______________________________________________________________
About how long have you known this person? ________________



By signing below, I certify that the information I have provided is true and correct.
I recognize that any misrepresentation or omission of information will result in my losing the
privilege of adopting a bull terrier.
I also give my veterinarian permission to release information about my current and past pets.
Completion of this application does not guarantee we will have a Bull Terrier that is a good
match, either now or in the future.
Thank you for taking time to complete the application!

Signature: ______________________________________             Date: _______

Signature: _________________________________________Date: _______


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