Adoption — UnbreakaBULL Pitbull Rescue

Which dog are you applying for?

Legal Name

First Name

Last Name

Date of Birth

YYYY

Phone

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Number of additional adults in home?

Legal Name of additional adult

First Name

Last Name

Date of Birth

YYYY

Phone

(###)

###

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Legal Name of additional adult

First Name

Last Name

Date of birth

YYYY

Phone

(###)

###

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How many children are in the home?

Ages of children in the home

How many animals currently reside in the home?

Gender

Name & Breed

Age

Gender

Name & Breed

Age

Gender

Name & Breed

Age

Up to date on vaccinations?

Spayed/Neutered

Have you adopted from any rescues before?

Rescue Contact Info:

If you have adopted from a rescue please provide the rescue contact information or name here, if no mark N/A:

Additional Pet Information (Please list any additional dogs/cats if more space is needed and any additional information you want to provide.)

Primary Vet Name (If there are no animals, please put NA)

First Name

Last Name

Vet phone number (If there are no animals, please put NA)

Vet Address (If there are no animals, please put NA)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have your animals received formal training?

If yes, please explain training methods

Check all that apply to your resident animals

Food aggression

Toy aggression

Seperation anxiety

Leash reactivity

Please explain any of the above behaviors selected

How does your resident animal react with children?

Does your resident animal show aggression to animals or humans?

Personal Reference

First Name

Last Name

Phone

(###)

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Personal Reference

First Name

Last Name

Phone

(###)

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Personal Reference

First Name

Last Name

Phone

(###)

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What is your experience with bully breeds?

How do you envision spending quality time with the dog?

Will you crate/kennel the dog?

How will you train the dog to enter the crate if not already trained?

How many hours a day will the dog be left alone?

How will the dog be exercised?

What behaviors are you NOT willing to work with?

Rescue dogs sometimes have unknown behavior issues. Are you willing to work with unexpected behaviors?

An expectation of adoption is following through with training. How will you go about training your rescue dog?

If yes, please explain

Will you pay for private or public obedience / manners training?

Do you own or rent a home?

Do you live in an Association

If yes, the name of the Association

Landlord Name

First Name

Last Name

Landlord Phone

(###)

###

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Do you have a yard?

Is your yard fenced?

If no, are you willing to purchase a fence?

How will the dog be supervised during potty breaks?

Do you have breed restriction free Homeowners/Renters insurance

If No, are you willing to switch insurance companies

Permission to speak to your insurance company

By providing your insurance information, selecting the yes option below, and by signing the bottom of this form electronically, you give Unbreakabull Pitbull Rescue of MN and its associates permission to contact your insurance company to verify that your insurance policy is active and to discuss what, if any, breed restrictions might be a part of your policy.

Homeowner or Renters Insurance Provider

Insurance Agent Name

First Name

Last Name

Insurance Agents Phone Number

Insurance Policy Number

Does your home owners/renters insurance protect against dog bites?

Do you live in a county that has breed restriction legislation?

The signature below affirms the intent to adopt or foster currently under ownership of UnbreakaBull

Date

YYYY

Any additional information you would like us to know?

Please fill out the adoption application completely and hit SUBMIT. Once the application has been submitted, it goes to our Application Coordinator via electronic submission. Once it is received, our coordinator will process the application and be in touch via PHONE or the EMAIL ADDRESS that you provided during the application process, so please verify that they are both correct before hitting submit. On occasion, an email will go to a SPAM/JUNK folder, so please remember to also look there for an email from us if it doesn’t appear in your inbox. Again, thank you for choosing UnbreakaBULL!!!

****Please allow 1-3 days for the application to be received and the process started.****