Hello Bully Adoption Application
Name:
Email:
Address:
City, State:
Zip:
Do you rent or own?
 Rent
 Own
 Years at address:
If you rent, we need written and verbal confirmation that your landlord will allow you to have a Pit Bull.
Landlord's Name:
 Landlord's Phone Number:
Home Phone:
Work Phone:
Cell Phone:
Best way / time to contact:
How many adults live at this residence?
Who will be the primary caretaker of the dog?
How many people under the age of 18? (Please include ages.)
If you have children, do they have experience with dogs?
 Yes
 No
What level of supervision will the children have when with the dog?
Has everyone in your household been included in the decision to adopt a Pit Bull?
 Yes
 No
If you answered no to the above question, please explain:
Does anyone in your household have allergies or asthma?
 Yes
 No
Occupation:
 Employer:
Date of Birth:
Have you ever owned a Pit Bull before?
 Yes
 No
Why do you want to adopt a Bully breed?
Does the county or city where you live have any Breed Specific Legislation?
 Yes
 No
 Don't Know
Tell us about any pets you currently own. Please include names, breeds, ages, and whether
your pets are spayed or neutered.
Please tell us about other pets you have owned. For each pet, please include the following
information: breed, age, length of ownership, how ownership ended. If the animal passed
away, please include the cause of passing. If the animal was rehomed, please provide details.
Please tell us what the dog's purpose in your life will be (Check all that apply):
Companion for other pet
Companion for myself
Guard dog for business
Companion for entire family
Guard dog for home/personal protection
Companion for child
Other (please explain):
Where will the dog spend most of his or her time?
Tied out in yard
Indoors with family
In fenced yard
Basement or garage
Outdoor Kennel
Indoor/Outdoor Kennel
Other (please explain):
What outdoor areas will your dog have access to? (Check all that apply.)
Enclosed dog run
Tie out (cable)
Unfenced yard
Tie out (chain)
Fenced Yard (Please describe type of fencing and height.)
How many hours a day will the dog be left at home alone?
Where will the dog spend his or her time when home alone?
Tied out in yard
Crate or indoor kennel
In fenced yard
Basement or garage
Free in house
Outdoor Kennel
Other (please explain):
Where will the dog sleep at night?
If you have other pets, how will they be managed when unsupervised?
How do you plan on exercising the dog?
Please tell us what your expectations are of the dog's behavior?
Knowledge of Basic Commands
Comes when called
Walks well on Leash
House trained
Other:
If behavior problems arise, are you willing to work with a trainer or behaviorist?
 Yes
 No
(Hello Bully offers free consultations and low-cost or free training.)
Under what circumstances would you decide not to keep your new dog?
New Roommate
Moving
Illness / Allergies
Separation or Divorce
Change in employment
Pregnancy or New Baby
Dog having behavior problems
New Carpet or Furniture
Veterinary Expenses
Other:
Please provide three references not related to you who we can contact to attest to your character.
Please include one Veterinarian if possible.
Is there anything else that you'd like us to know about you as a potential adopter?
By checking yes, I understand that Hello Bully reserves the right to refuse
adoption at their discretion.
Yes
 No
By checking yes, I agree that the dog will be kept as a companion house pet.
The dog will not be used in any medical experimentation or illegal activities.
Yes
 No
By checking yes, I understand that some insurance companies may deny or
discontinue coverage based on the breed of dog I own. I agree to check with my
insurance company prior to adoption. (We recommend State Farm.)
Yes
 No
By checking yes, I agree not to sell, trade, transfer ownership, abandon, or
dispose of this dog in any way, nor release the dog to any family member or
friend, but rather if for any reason I am unable to keep this dog at any point
in the future, to contact Hello Bully to assist me in finding a new,
appropriate home for this dog.
Yes
 No
By checking yes, I agree  to allow representatives of Hello Bully to examine the
dog and his or her living conditions at any point in the future, and to relinquish the
dog if the conditions are found unsatisfactory. I further agree that I will not house
the dog outdoors, even if in accordance with state and local laws.
Yes
 No
By checking yes, I understand that representatives of Hello Bully will contact
the references I have provided and discuss my suitability as an adopter. Hello
Bully may also schedule and conduct a home or property check and a criminal
background check at their discretion.
Yes
 No
By checking yes, I agree that I have never been convicted of a crime involving the
neglect, abuse or other illegal activity relating to an animal.
Yes
 No
By checking yes, I agree to abide by all state and local leash laws. As a
responsible Pit Bull owner I will NEVER let my dog roam free. I will never take my
Pit Bull to a dog park or other off leash facility. I will supervise or separate my Pit
Bull from other dogs or animals in my home.
Yes
 No
By checking yes, I absolve Hello Bully and all of their representatives and
members from any and all liability relating to or resulting from, now or in the
future, the ownership of a dog adopted from them. Upon adoption, I agree
to assume full responsibility for the dog and the dog's actions, including any
and all damages done by the dog.
Yes
 No
By checking yes, I agree that the information I have provided in this application is
true and I agree to abide by all the conditions listed above.
Yes
 No
If you are interested in a specific dog(s), please list here:
If you don't see a dog you're interested in, but you'd like
us to help you find the right dog, please list any physical
or behavioral characteristics you are looking for: