Name (required)
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First Name
Last Name
Email (required)
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Home Phone
(###)
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Years at current address
Mobile Phone
(###)
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Work Phone
(###)
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Best way to contact you
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Home Phone
Mobile Phone
Work Phone
Email
Best time to contact you
Do You:
If you rent, we need written and verbal confirmation that your landlord will allow you to have a dog and/or Pit Bull.
Landlord's phone
(###)
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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?
What level of supervision will the children have when with the dog?
Your Occupation
Your Employer
Date of Birth
MM
DD
YYYY
Does anyone in your household have allergies or asthma?
Does anyone in your household have any physical limitations that would prevent them from caring for an active dog?
Have you ever owned a dog before?
Why do you want to adopt this dog?
Does the county or city where you live have any Breed Specific Legislation?
Please tell us about any pets you currently own. Please include names, breeds and ages.
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)
Where will the dog spend most of his/her time?
What outdoor areas will your dog have access to?
(Check all that apply)
How many hours a day will the dog be left at home alone?
Where will the dog spend his/her time when home alone?
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?
What types of training methods do you plan on using with your newly adopted dog?
Do you plan on taking your adopted dog to an obedience or training class?
If yes, is there a specific trainer or facility you plan on using?
Please tell us what your expectations are of the dog's behavior?
(Check all that apply)
If behavior problems arise, are you willing to work with a trainer or behavior professional?
(Hello Bully offers free consultations and free or low-cost training assistance.)
Under what circumstances would you decide not to keep your new dog?
(Check all that apply)
Please provide three references (not related to you) who we can contact to attest to your character.
(Please include contact information. IF POSSIBLE, please include at least one Veterinarian.)
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 and/or the current caretaker reserve the right to refuse adoption at their discretion.
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.
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 if the dog is a Pit Bull.
By checking yes, I understand that Hello Bully and/or the current caretaker will contact the references I have provided. They may also conduct a home or property check and a criminal background check at their discretion.
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.
By checking yes, I absolve Hello Bully and the current caretaker from any and all liability relating to or resulting from the ownership of a dog adopted from them. Upon adoption, I agree to assume full responsibility for the dog's actions, including any and all damages done by the dog.
By signing below, I agree that the information I have provided in this application is true and I agree to abide by all the conditions listed above.
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First Name
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Today's Date
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