MID-AMERICA BULLY BREED RESCUE ADOPTION APPLICATION

Please fill out the application form honestly and completely. We cannot process incomplete applications. Though the application is one step in our adoption process, it is the first opportunity we have to get to know you and it is an important part of our being able to make the best adoption match. YOU MUST BE 21 YEARS OF AGE TO APPLY.

Date: *

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip Code: *

Email Address: *

Phone Number: *

Occupation: *

Tell us your age: *

By checking YES, you agree that the dog will not be used for any illegal activities nor found at any time in a municipality where the breed is illegal. *

Yes

By checking YES, you agree that the dog is to be kept as a house pet. It shall not be used for medical or any other experimental purposes. *

Yes

Why do you want to adopt a dog? *

How soon do you want to adopt? *

Please provide the name of the dog(s) you are interested in adopting.

Choice (1): *

Choice (2):

Choice (3):

Do you prefer a male or female?

Male

Female

Either

Do you prefer an adult or puppy?

Adult

Puppy

Either

What energy level would work with your lifestyle? *

Active

Mellow

Do you have a color or weight preference of your new pet?

Do you own or rent your home? *

Homeowner

Renter

Describe your yard and fence: *

If renting, does your landlord allow pets? *

I own my home and do not need approval from a landlord

My landlord does not allow pets and I am planning to relocate soon

Yes, my landlord allows pets

If renting, does your landlord know you are looking for a new pet? *

Yes

If renting, are you required to pay a pet deposit? *

Yes

If renting, please provide Landlord's name and phone number. We cannot process your application without this information. *

Tell us about the members in your household. List all household members including their age, sex and relationship to you. (Example:. Mary, 12 years old, daughter) *

Are all the members in your household in agreement about adopting a dog? *

Yes

I haven't told them yet

What other pets do you currently own? Please be specific with AGE, SEX AND BREED. *

Are your current pets spayed or neutered? *

Yes

N/A

If your pets are not spayed/neutered, please tell us why: *

Tell us about the pets you have owned in the past: *

Have you ever had to rehome a pet? If so, please explain the circumstances: *

What circumstances would prevent you from keeping a dog for the rest of its life? *

What will you do if you cannot keep your dog? *

Do you have a contingency plan in place for your pets if something were to happen to you? *

How many hours each day will your new pet be home alone? *

Where will your pet be kept at night or when you leave your home? *

Do you travel for business or vacation? *

Yes

If yes, who will provide for your pet(s) while you are away? *

What traits would you find unacceptable in your new pet?

What steps would you take to correct unwanted behavior? *

Are you willing to work through unexpected hardships with your dog and hire a trainer if needed? *

Not sure

Yes

Describe any experience you have had with obedience training or with medical or behavioral issues. *

What kind of activities do you or will you do with your pets for fun and/or exercise? *

What restrictions would you place on your dog's interaction with children? *

What restrictions would you place on a child's interactions with your dog? *

Of all the breeds available, why are you interested in adopting a pit bull? *

Please describe any experience you have had with bully breed dogs: *

Do you know what Breed Specific Legislation is? *

Tell us in a few words what you know about Breed Specific Legislation: *

Tell us how you feel about Breed Specific Legislation: *

Do you have Breed Specific Legislation in your city? If so, please describe the restrictions or ordinance: *

Have you thought about and are you prepared to deal with the discrimination that may come from owning a bully breed of dog, i.e. homeowners insurance, neighbor relations, community bias? *

Are you prepared for the financial responsibility that comes with owning a dog? *

Yes

Please supply the name and phone number of your current veterinarian: *

Please supply the name and phone number of an employer, friend or someone NOT related to you that can attest to your character: *

Are you willing to travel to meet your new pet? If so, how far? *

Please provide any additional information you would like us to know about your home, family and why you are applying for a rescue dog: *

How did you hear about MABBR? *

Press submit only once. It may take a few moments for the application form to load. You will be redirected to a confirmation page when your application is submitted.

Thank you for your interest in an MABBR Incredi-Bull!