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ADOPTION APPLICATION - ADOPTION AGREEMENT

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					Born Again Pit Bull Rescue                               P.O. Box 1321 | Sherwood, OR | 97140
        (BAPBR)                                                                 503-888-4583
                                                                          BAPBR@yahoo.com

                            BAPBR Adoption Application
    BAPBR strives to find life long homes for our dogs. We ask that you only consider adopting one
    of our dogs if you can guarantee it a home for its lifetime.

    Name of Dog I am interested in
    adopting:
    PERSONAL INFORMATION
    Applicant Name(s):

    Address:

    City:

    State and Zip:

    Home Phone:

    Cell Phone:

    E-Mail:

    How many children live in your home?

    What are their ages, if appl.?

    HOUSEHOLD INFORMATION

    Please describe any current DOGS that you have:
    Breed          Name           Age       Sex        Spay/Neutered        Current on Vaccinations




    Please describe any current OTHER pets that you have:
    Species (Cat, Bird, Reptile, etc)  Name                         Age           Sex     Spay/Neutered




    Please describe any PAST pets you have owned:
    Species (Dog, Cat, Bird, Reptile)  Last Known Age        Sex      What Happened to this pet?




    BAPBR Adoption Application                                                                       1
Born Again Pit Bull Rescue                                    P.O. Box 1321 | Sherwood, OR | 97140
        (BAPBR)                                                                      503-888-4583
                                                                               BAPBR@yahoo.com

    Why do you want a dog?

    How many hours a day will this pet be left alone? Please
    explain.
    Where will this dog stay during the day?

    Where will this dog stay during the night?

    Do you have a securely fenced in yard?

    PET CARE INFORMATION
    Do you currently have a veterinarian?

    Please provide your vet's name.

    Will you be able and willing to regularly exercise this adopted
    dog?
    Please describe your method of exercise:


    Are you willing and able to take care of this pet for its natural
    lifetime?
    If for some reason you are not able to care for this pet in the
    upcoming future, what will you do with this adopted dog?

    Have you ever given a pet to a shelter/humane society?

    If YES, what was the reason for giving up the pet?

    For Pit Bull adoptions:

    Do you have any previous experience with this breed?

    If YES, please explain:


    PERSONAL REFERENCES
    List one non-relatives who can verify that you are a responsible, reliable and caring person
    Name:                                             Phone Number:


    I certify that the above information is true and accurate to the best of my knowledge and that I
    understand that falsification of information can be cause for denial of my application or future
    forfeiture of the adopted pet. Leaving questions blank or not filling out this form completely can be
    cause for the application to be discarded or denied.

    Date: ______________________

    (type or sign) Signature/Name of applicant(s):


    __________________________________                       _____________________________



    BAPBR Adoption Application                                                                         2

				
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