Adoption Application Adoption Application Our goal is to place pets in permanent, loving homes. Please complete this application and contract so Alamo City Pit Bull Rescue and Rehabilitation may assist you in finding a special, compatible companion to join your family. With this information, we Alamo City Pit Bull Rescue and Rehabilitation minimize the risk of a failed adoption. We do NOT adopt dogs on a “first come, first served” basis, but rather make every attempt to match families with the most compatible pets. WE RESERVE THE RIGHT TO DECLINE ANY APPLICATION FOR ANY REASON. The customary adoption fee for pets is $150 for dogs and $200 for medical dogs. These fees help to defray the costs of spaying/neutering, testing, vaccinating, and micro-chipping our pets, but rarely, if ever, cover all expenses. Therefore, additional contributions are welcomed. Adoption fees and donations are NOT refundable. Our dogs are heartworm tested and placed on heartworm preventative. 1 About You2 About Your Potential Pet3 About Your Home4 Pit Bull and Rescue History5 Pet Ownership History6 References7 Electronic Signature Today's Date* Name* First Last Email* Phone Number*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you at least 21 years old?* Yes No You must be 21 years old to adopt.Date of Birth*Driver's License Number and State*Employer*What are your working hours?* Name of the dog in which you are interested*Where did you see or hear about this dog?*Why do you want to adopt a dog?*Where would your pet stay while you are away?*IndoorsOutdoorsBothWhat will you do with this pet if you have to move?What will you do with the pet when you travel?*How long would the pet be left alone? Where will your pet be left when he/she is alone?*Do you plan on having your animals ears cropped or tails docked? If so, at what age and by whom?How would you exercise the pet?*How would you handle the dog’s potty needs?*Do you have a pet door?YesNoI plan to install oneHave you housetrained an animal before?YesNoI'd like tips on how to do thisIf you have housetrained, describe how you accomplished thisAre you willing/able to purchase and use a crate if needed or advised?*YesNoWhere would the pet sleep?*Where would it sleep in bad weather?* Do you rent or own?*RentOwnLive with parentsWhich describes your current residence?*HouseApartmentTownhomeDuplexCondoDoes every adult in the household agree on owning this pet?*YesNoDoes anyone in the household have allergies? If so, are they allergic to animal dander?*Please list all members in your household and their ages:*Are you aware that apartments and rentals generally do NOT allow Pit Bulls or other bully breeds? What would you do in the instance you had to rent a home? What if your job requires you to move frequently (ex: military)?*If renting, does your lease allow pets?Breed or weight restrictions?Pet deposit required? (We will need confirmation of payment)Rental manager’s name and phone numberDo you have a fenced yard?*YesNoWhat type of fence and how high? Have you owned this breed/mix before?*YesNoHave you owned a rescued animal before?*YesNoIf so, what group/shelter?Have you applied to adopt an animal and been declined?*YesNoIf so, why?Have you ever given up animal(s)?*YesNoIf so, why and what did you do with the animal?Under what circumstances would you ever give up/re-home your pet?*Under what circumstances would you chain up your dog?*Why did you choose this particular breed?*What qualities are you looking for in a pet? Check all that apply.* good with kids (ages 0-2) good with kids (ages 3-9) good with kids (ages 10+) good with other dominant dogs good with other submissive dogs good with cats crate trained leash trained potty trained Low Energy Medium Energy High Energy Any other qualities not listed?What is the purpose of this pet?* guard dog companion family dog other Please specifyWhat traits or characteristics are you sure you do NOT want? (Please be specific, please also indicate activity level you are looking for in a pet)*Do you give permission for a Alamo City Pit Bull Rescue and Rehabilitation representative to visit your home prior to adoption to do a home check and after adoption to do follow up checks on the pet?*YesNoHow did you hear about Alamo City Pit Bull Rescue and Rehabilitation and/or the pet you are applying for?* Do you currently have any other pets in the household?*Yes I currently have petsNo I currently do not have pets, but I have owned pets in the pastNo I currently do not have pets, I have never owned pets beforePast Pets*Please state the breed, sex, etc. of each pet, including whether it was spayed or neutered, on heartworm preventive, and how and when the pet was acquired and why you no longer have the animal.Are your current pets spayed/neutered?*YesNoDo not have petsPlease explain why*Are your pets current on vaccinations?*YesNoDo not have petsPlease explain why*Are your pets on heart worm and flea preventatives?*YesNoDo not have petsPlease explain why*Copy and paste the following and complete in the text box for each pet: Name? Dog or cat? How acquired? Breed? Male or Female? Spayed/neutered? Age of pet? Length of ownership? Heartworm preventative? What kind of Heartworm preventative? When last given? Is your pet current on all shots? If no, please explain. Where does this animal sleep? Where does the pet stay while you were away or at work? Does this pet have any problems or conditions?Pet #1Pet #2Pet #3Pet #4 Please list a vet reference (name + phone number)*Please list TWO PERSONAL references (ex: co-worker, friend, etc.). Please provide their first and last name, phone number and how you know these people.*Please list TWO PROFESSIONAL references (ex: manager/boss at work, Veterinarian, etc.). Please provide their first and last name, phone number and how you know these people.* PLEASE SIGN FIRST AND LAST NAME. By typing your full name below this serves as your handwritten signature and you attest that all information submitted is true and correct to the best of your knowledge.* This iframe contains the logic required to handle Ajax powered Gravity Forms.
