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 *

Email Address *

Alternate Phone Number

Date of Birth *

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 *

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.

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:

Will you allow us to perform home checks? *

Please provide the names and phone numbers for 3 references that are not related to you. *

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. *