Bratpack Adoption Application
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| Breed(s) desired:
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| Applicant full name:
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| Note: Applicant must be over 21 years of age
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| Applicant age:
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| Co-applicant full name:
| Note: Co-applicant must be over 21 years of age
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| Co_applicant age:
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| Email address:
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| Re-enter email address:
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| Address
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| Daytime phone number:
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| Evening phone number:
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| Cell phone number:
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| Why do you want a dog at this time:
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| Why do you want this breed?
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| Would you accept a dog over 20 lbs?
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| Would you consider a special needs dog?
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| Would you consider a dog who is not fully housebroken?
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| What are your thoughts on the use of a crate for your dog?
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| Applicant's occupation:
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| Applicant's place of employment:
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| Applicant's work phone:
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| Co-applicant's occupation:
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| Co-applicant's place of employment:
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| Co-applicant's work phone:
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| What type of home do you live in? (single family, apartment, condo, mobile home, etc.)
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| Do you rent or own?
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| If you rent, please provide landlord's name and phone number:
| You will be required to provide proof of pet clause in lease prior to having a dog placed with you.
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| How long have you lived at this address?
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| How long did you live at your previous address?
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| Please list all people currently living at this residence, their ages, and their relationship to the applicant:
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| Do you have a pool or hot tub?
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| If so, is it fenced/covered so that a dog CANNOT get to it? Explain if necessary?
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| Do you have a completely fenced area on your property?
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| If not, please tell us how you will address the dog's need for exercise, bathroom needs, etc:
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| Home visits are required by rescue. Is this acceptable?
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| Days and times you are available:
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| Do adults work full-time, part-time, or not at all?
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| Is anyone home while you are working? Who? Will they be responsible for taking care of the dog's needs?
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| How many hours each day will your dog be alone on weekdays? Weekends? Evenings?
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| If you will be gone more than 6 hours, how do you plan to potty, exercise and socialize your dog during the time the dog is alone? (Come home for lunch, have petsitter or neighbor come over, etc.) Please be specific.:
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| Where will your dog be kept during the day? (loose indoors, crate, basement, laundry room, kitchen, other confined room, fenced yard, chained outside, dog run, on lead attached outside, loose outdoors, garage, dog house, etc.) Please be specific:
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| Where will the dog sleep at night? Again, be specific:
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| Who will be responsible for feeding the dog?
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| Who will be responsible for housebreaking the dog, if necessary?
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| How much experience does this person have in housebreaking and training?
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| How would you handle housetraining?
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| Who will care for the dog in the event you are ill, on vacation, or otherwise incapacitated:
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| Have you, as an ADULT, owned a dog before?
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| Yes No
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| If it is no longer with you, please provide a brief explanation of what happened:
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| Have you ever had an animal die at an early age?
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| Yes No
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| If yes, please explain:
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| Have you ever given an animal to another person, rescue or shelter:
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| Yes No
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| If yes, please explain:
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| Please list below any pets who currently live in the house. Include their name, breed, sex, age, years owned, and whether they are neutered:
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| Are these animals up to date on shots, heartworm preventative, veterinary care, etc?
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| Yes No
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| If not, please specify which ones and why:
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| Please describe the kind of dog you are looking for (age, sex, size, etc.)
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| Note: If you are applying with a specific dog in mind, please note that here. If that dog is no longer available, please state if you want your application to remain on file for another dog.
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| Name of current veterinary hospital:
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| Vet's phone number:
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| Vet's full address:
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| Approximate date of last visit:
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| Reason for last visit:
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| What owner's name are the records listed under:
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| Groomer reference- if you have a groomer you have used before, please list the name & phone number here:
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| Additional comments
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Image Verification
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