Bossy Paws Rescue Adoption Application for Dogs

Animal you are interested in adopting
Applicant's First Name *
Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Phone Number * Please use the following format 248-555-1212
Email Address * Please enter correctly as this is the main way we will contact you
Alternate Phone Number
Are you interested in multiple animals or pairs? (list the name of additional animals of interest) * *
How did you find out about us?
Have you applied anywhere else for a pet? *
Is this pet for you or someone else? *
What other pets do you own, please list their names, breeds, and ages? *
Are all of your pets spayed/neutered/fixed? *
How many pets have you owned in the last 5-10 years? *
What happened to them? *
Are your pets current on their vaccinations? *
Have you ever turned your dog or cat into a shelter? If yes, please explain? *
Veterinarian's Name & Phone Number * If you have never owned a pet please tell us where you would go.
Have you ever had a pet euthanized? If yes, please explain: *
What preventative flea/tick/heartworm medication do you prefer? *
Were any of your pets obedience trained? *
Please check the main reason you plan to adopt a pet: *
If you answered "other" above, please explain here: *
Please describe in detail the pet you are looking for. *
Do you own or rent your home? *
Please select your current residence type. *
If you answered "other" above, please explain here:
How long have you lived at this address? *
If you rent, does your landlord and lease allow pets? *
Including yourself, how many people live in your household? *
Please list the ages & relationship of those who live in your home (including yourself). *
Is everyone in your household aware that you are planning to adopt a pet? *
Does anyone in your household have allergies to dogs/cats? *
Employment Status *
If you chose "other" above, please explain:
On average, how many hours per day will your pet be left alone? *
How much do you think the annual medical bills will be for your pet? *
What would you do if the bills went over this amount? *
Will this pet be predominantly living inside, outside, or both? *
Please provide a description of this pet's living conditions. *
Do you have a completely fenced-in yard? If so, what kind of fence? *
If you answered "other" above, please explain:
If you do not have a fenced yard, how will you let the animal out? *
Are there times when the animal will be tied/chained up? *
If yes, when will they be tied/chained up?
Where will the animal sleep? *
If you answered "other" above, please explain:
Will the animal spend any time in the garage? *
If the animal will spend time in the garage, please explain when/why:
How will you handle housebreaking? *
How will you handle destructive behavior? *
Will you keep the animal up-to-date on vaccinations and heartworm preventative? *
If no, please explain:
Are you willing and able to exercise the dog on a regular basis? *
If yes, what is the method of exercise?
If you answered "other" above, please explain:
Have you ever been convicted of abuse or neglect of a child or animal? *
If yes, please explain:
If you drive a pick up truck, would you allow the animal to ride in the back/bed? *
What arrangements will you make for the care of your pets in case of an emergency? *
If you answered "other" above, please explain:
What will you do with the animal when you go on vacation?
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal? *
What would you do with your animal if you had to move? *
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 10-20 years? *
If no, please explain:
Are you open to a special needs animal? *
Will you allow us to perform home checks? *
Please provide the name and phone number for a reference not related to you. *
Please provide the name and phone number for a reference not related to you *
Please provide the name and phone number for a reference *
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *