******************ATTENTION*************************
If you are interested in a PUPPY MILL DOG please do not ask us if the dog is housebroke! These dogs have lived for years in a wire cage without human contact!!!!! Our first priority is to get these dogs used to human contact and to also get them in a healthy mental and physical state FIRST! PLEASE READ THE PUPPY MILL TAB AT THE TOP OF THIS PAGE!
If you have found a dog that you are interested please fill out one of the forms below. The first application is specifically for Pit Bulls and the second application is for all the other dog breeds that we have rescued.
Cat applications is the last application on this page!
For your convenience there are three ways to complete and return the application:
Please be advised that we do not refund the adoption fees. A dog is a lifetime commitment. They are not a spur of the moment commodity item. Some dogs may have adjustments periods or some slight behavior problems, i.e. barking and chewing. If you are not willing to seek training to help your potential rescue, then you are not ready for a dog. Before you are ready to adopt, remember, they are not a commodity item that can be returned for your money!
Country Kennel Bully Rescue Adoption Application
For Pit Bulls
PLEASE READ CAREFULLY!
Thank you for taking the time to fill out our questionnaire. The purpose of this application is to learn a little more about your family and home so that our organization can make the best possible match for both you and our bullies. Our main concern is placing our animals in a compatible home with a family that will give them a LIFETIME commitment of love and proper care. We realize some of the questions may seem too personal or strange to ask, but we have specific reasons for them based on previous experience in the adoption process. This consultation process is designed to help us determine if the adoption is in the best interest for both the bullies and the adopter. Please be aware that while completing this application does not bind you to adopt one of our animals, neither does it guarantee that we will place one of our bullies in your home at this time. If you are interested in learning more about one of our rescues, please answer the questions honestly and thoroughly.
Some of our bullies may need extra time and patience to adjust to yet another new home. Some may need housetraining or other types of training, and some may need a little extra love and patience. All bullies, regardless of their background and history, go through an adjustment period when they go to a new environment. There will be a period of a few days, weeks, or in some cases months during which your new bully's personality is emerging and growing while you get to know one another. Please remember that this is a stressful time for an animal and hopefully we will be able to work together to make this a lifetime relationship for you and your bully. You can call on us any time to help you in any way.
We reserve the right to refuse adoption to anyone for any reason. A representative of Country Kennel Bully Rescue may conduct home visits prior to or following the adoption, and our group has the right to reclaim an animal following an adoption if unsuitable home conditions, misrepresentation of self, evidence of neglect, abuse or other mistreatment of the bullies are found on this visit. Any animal adopted from Country Kennel shall be returned at any and all times, if no longer able to keep or no longer wanted.
IN ORDER TO BE CONSIDERED AS AN ADOPTER TODAY,YOU MUST
ü Be 21 years of age or older
ü Have identification showing your present address
ü Have the knowledge and consent of your landlord
ü Be willing to possibly have a rescue representative visit your home by appointment
ü Be able and willing to spend the time and money necessary to provide training, medical treatment, and proper care for a dog for the entire life of that animal
Please initial here to show you have read and understand the process and guidelines.________________
Date_____________________
Name/Spouse’s name _____________________________________________________
Address:__________________________________________________________________
Phone number(s) and type(s)_____________________________________________________________________
Email___________________________________________________
Best way/time to contact you_______________________________
Is there a specific dog you are interested in adopting from us? If yes, please indicate the dog’s name and tell us why this particular one. If no, please tell us if there is anything specific you are looking for. _________________________________________________________________________
Occupation/Spouse’s Occupation________________________________________________________________
_________________________________________________________________________
Do you have children? If yes, what are their ages?_____________________________________________________
Is this the first time owning a bully breed?___________________________________________________________
What interests you in the breed?_________________________________________________________________________
_________________________________________________________________________
Please list the names and ages of the people living in the residence: _________________________________________________________________________
_________________________________________________________________________
Do you own or rent?______If you rent what is your landlord’s name and number?
________________________________________________________________________
Do you have a fenced in yard? If yes, please tell us the type of fence and how high it is.______________________
_________________________________________________________________________
What pets do you currently have in your household? For each, please give us the following information: dog/cat, name, age, whether the animal is altered, and whether it is kept indoor/outdoor/both________________________________________
_________________________________________________________________________
Your veterinarian’s name, hospital, city, and phone number:
_________________________________________________________________________
_________________________________________________________________________
Reference #1: Please provide his/her name, phone number, (and email if possible)_________________________________________________________________________
Reference #2 _________________________________________________________________________
Do any family members have pet allergies? If so, please provide details regarding specifics and severity.
_________________________________________________________________________
Why have you decided to adopt a bully?_________________________________________________________________________
Will this be your first bully?_________________________________________________________________________
What other animals have you owned before?_________________________________________________________________________
_________________________________________________________________________
Have you ever: lost a pet, surrendered a pet to a shelter/rescue, given a pet away or placed a pet in another home? If so, please explain. _________________________________________________________________________
_________________________________________________________________________
Have you had any puppies/dogs in your household within the past year with parvo, distemper, kennel cough, mange, or coccidia? If so please explain how long ago, what treatment options were used, and the final outcome.
_________________________________________________________________________
Have your current or previous pets been kept up-to-date on annual vaccines and been tested for heartworm?____
Are your current pets on heartworm preventative? If so, what kind. ______________________________________
Is someone home during the day?___________ Longest number of hours expected to be gone at one time ______
What are the work hours of all household members? _________________________________________________________________________
Where will the pet be kept during the day and night _________________________________________________________________________
Who will be the bully's primary caretaker? __________________________________________________________
Please describe your exercise plan for your bully _________________________________________________________________________
_________________________________________________________________________
Describe your house-training method _________________________________________________________________________
_________________________________________________________________________
Are you willing to obtain a crate and crate train the bully, if necessary? ___________________________________
Are you willing to take the bully to basic obedience class, if necessary? ____________________________________
What would you do if the dog bit somebody? _________________________________________________________________________
_________________________________________________________________________
Excluding your death, what conditions or circumstances would cause you to give up an animal? ________________________________________________________________
_______________________________________________________________________
What arrangements have been made to ensure your pets will be cared for if something would happen to you if you were no longer able to care for them or in the event of your death? (sorry have to ask)
_________________________________________________________________________( please be willing to provide contact information)
By checking YES, you agree to absolve Country Kennel Bully Rescue from any liability in the adopted bully and in this organization ____yes ____no
By checking YES, you agree that the dog will not be used in any illegal activities nor be found at any time in a municipality where a bully breed's presence is illegal
____yes ____no
By checking YES, you agree to abide by all state/local leash laws. You understand it is your responsibility to research and learn your state and local laws. ____yes ____no
After reading each line, please INTIAL.
____ Bully breeds are great escape artists especially if bored, it might take more than just a fence to keep your pet contained.
____ You should never leave your bully unattended with other pets. Even with the help of socialization, this confident breed can be pushed to fight if sufficiently challenged by another dog
____ Crates should never be used for punishment. Dogs are den animals – A crate is a den where they go to feel safe.
____ Bully breeds are very strong and are bred to have a high pain tolerance. They need solid and sturdy collars that won’t break under tension.
PLEASE ADVISE!
Country Kennel does not guarantee the health of this animal. We do routine vaccines, spays and neuters and anything else that to our knowledge might be wrong. Some animals might have underlying health issues that we do not know about. Please understand that we do the most we can with these animals with what limited resources we have. Initial here if you have fully read and understand this statement _________
Please sign your name here
_________________________________________________________________
Application for all other dogs:
Country Kennel Bully Rescue Adoption Application
PLEASE READ CAREFULLY!
Thank you for taking the time to fill out our questionnaire. The purpose of this application is to learn a little more about your family and home so that our organization can make the best possible match for both you and our rescued dogs. Our main concern is placing our animals in a compatible home with a family that will give them a LIFETIME commitment of love and proper care. We realize some of the questions may seem too personal or strange to ask, but we have specific reasons for them based on previous experience in the adoption process. This consultation process is designed to help us determine if the adoption is in the best interest for both the dog and the adopter. Please be aware that while completing this application does not bind you to adopt one of your animals, neither does it guarantee that we will place one of them in your home at this time. If you are interested in learning more about one of our rescues, please answer the questions honestly and thoroughly.
Some of our rescued dogs may need extra time and patience to adjust to yet another new home. Some may need housetraining or other types of training, and some may need a little extra love and patience. All rescues, regardless of their background and history, go through an adjustment period when they go to a new home. There will be a period of a few days, weeks, or in some cases months during which your new friend's personality is emerging and growing while you get to know one another. Please remember that this is a stressful time for an animal and hopefully we will be able to work together to make this a lifetime relationship for you and your rescue. You can call on us any time to help you in any way.
We reserve the right to refuse adoption to anyone for any reason. A representative of Country Kennel Bully Rescue may conduct home visits prior to or following the adoption, and our group has the right to reclaim an animal following an adoption if unsuitable home conditions, misrepresentation of self, evidence of neglect, abuse or other mistreatment of the animals are found on this visit.
Any animal adopted from Country Kennel Bully Rescue is required to be returned at any and all times, if no longer able to keep or no longer wanted!!!
IN ORDER TO BE CONSIDERED AS AN ADOPTER TODAY, YOU MUST
Date _____________
Name/Spouse’s name ________________________________________________________________________
Address___________________________________________________________________________________
Email___________________________________________________________________
Phone Number and Type______________________________________________________________
Is there a specific dog that you are interested in adopting from us? If yes, please indicate the dog’s name and tell us why this particular one. If no, please tell us if there is anything specific you are looking for. __________________________________________________________________________________________
__________________________________________________________________________________________
Occupation/Spouse’s Occupation________________________________________________________________
__________________________________________________________________________________________
Do you have children? If yes, what are their names and ages?___________________________________________
__________________________________________________________________________________________
Please list the names and ages of any other people living at the residence:___________________________________
__________________________________________________________________________________________
Are you a first time pet owner? If no, please list the other pets previously owned and explain where are they now.______________________________________________________________________________________
__________________________________________________________________________________________
Do you have a fenced in yard?_________ If yes, please tell us the type of fence and how high it is __________________________________________________________________________________________
Your veterinarian’s name, hospital, city, and phone number:_____________________________________________
__________________________________________________________________________________________
Please provide two references, include their name, phone number, (and email if possible)
Reference #1______________________________________________________________________________
_________________________________________________________________________________________
Reference #2_______________________________________________________________________________
_________________________________________________________________________________________
Do any family member have pet allergies? If so, please provide details regarding specifics and severity ____________
_________________________________________________________________________________________
_________________________________________________________________________________________
Have you ever: lost a pet, surrendered a pet to a shelter/rescue, given a pet away or placed a pet in another home? If so, please explain___________________________________________________________________________
________________________________________________________________________________________
Have you had any puppies/dogs in your household within the past year with parvo, distemper, kennel cough, mange, or coccida? If so, please explain how long ago, what actions where taken and the final outcome. _________________
________________________________________________________________________________________
Have your current or past pets been kept up to date on annual vaccines and been tested for heartworm?________________________________________________________________________________________
Are your current pets on heartworm preventative? If so, what kind?_____________________________________
________________________________________________________________________________________
Is someone home during the day?_________Longest number of hours expected to be gone at one time __________
________________________________________________________________________________________
What are the work hours of all household members?_________________________________________________
________________________________________________________________________________________
Where will the pet be kept during the day and night?_________________________________________________
________________________________________________________________________________________
Who will be the pets primary caretaker?__________________________________________________________
Please describe your exercise plan for your pet_____________________________________________________
________________________________________________________________________________________
Describe your housetraining method_____________________________________________________________
________________________________________________________________________________________
Are you willing to obtain a crate and crate train your pet if necessary?____________________________________
________________________________________________________________________________________
Are you willing to take your rescue to basic obedience class if necessary?_________________________________
________________________________________________________________________________________
What would you do if the dog bit somebody?______________________________________________________
________________________________________________________________________________________
Excluding your death, what conditions or circumstances would cause you to give up an animal?_________________
________________________________________________________________________________________
What arrangements have been made to ensure your pets will be cared for if something would to happen to where you were no longer able to care for them or in the event of your death? (Sorry have to ask)_______________________
________________________________________________________________________________________
By checking YES, you agree to absolve Country Kennel Bully Rescue from any liability pertaining to the adopted pet or this organization ____yes ____no
By checking YES you agree that the pet will not be used in any illegal activities nor be found at any time running loose ____yes ____no
By checking YES you agree to abide by all state/local leash laws. You understand it is your responsibility to research and learn your state/local laws, and rental laws/rules ____yes ____no
PLEASE ADVISE!
Country Kennel does not guarantee the health of this animal. We do routine vaccines, spays and neuters and anything else that to our knowledge might be wrong. Some animals might have underlying health issues that we do not know about. Please understand that we do the most we can with these animals with what limited resources we have. Initial here if you have fully read and understand this statement _________
Please sign and date the line below
PLEASE READ CAREFULLY!
Thank you for taking the time to fill out our questionnaire. The purpose of this application is to learn a little more about your family and home so that our organization can make the best possible match for both you and our rescued cats. Our main concern is placing our animals in a compatible home with a family that will give them a LIFETIME commitment of love and proper care. We realize some of the questions may seem too personal or strange to ask, but we have specific reasons for them based on previous experience in the adoption process. This consultation process is designed to help us determine if the adoption is in the best interest for both the cat and the adopter. Please be aware that while completing this application does not bind you to adopt one of your animals, neither does it guarantee that we will place one of them in your home at this time. If you are interested in learning more about one of our rescues, please answer the questions honestly and thoroughly.
Some of our rescued cats may need extra time and patience to adjust to yet another new home. Some may need housetraining or other types of training, and some may need a little extra love and patience. All rescues, regardless of their background and history, go through an adjustment period when they go to a new home. There will be a period of a few days, weeks, or in some cases months during which your new friend's personality is emerging and growing while you get to know one another. Please remember that this is a stressful time for an animal and hopefully we will be able to work together to make this a lifetime relationship for you and your rescue. You can call on us any time to help you in any way.
We reserve the right to refuse adoption to anyone for any reason. A representative of Country Kennel Bully Rescue may conduct home visits prior to or following the adoption, and our group has the right to reclaim an animal following an adoption if unsuitable home conditions, misrepresentation of self, evidence of neglect, abuse or other mistreatment of the animals are found on this visit.
Any animal adopted from Country Kennel Bully Rescue is required to be returned at any and all times, if no longer able to keep or no longer wanted!!!
IN ORDER TO BE CONSIDERED AS AN ADOPTER TODAY, YOU MUST
| Name _____________________________________________________________________________________ Date ____/____/________ |
| (Please print name(s) of all adults in the home) |
| Address __________________________________________________________________________________________________________ City ____________________________________ County ______________________ State _________________ Zip Code ___________ Home Phone _______________________________ Work ______________________________ Cell _____________________________ If we may use e-mail to contact you, please include an address _______________________________________________________________ DO YOU: Attend School _____ Work _____ Employer ___________________________ Spouse's employer ________________________ DO YOU LIVE IN A: House _____ Apartment _____ Condo _____ Dorm _____ Mobile Home _____ DO YOU: Rent _____ Own _____ Live with Parents _____ Landlord's Name _________________________________________________ Landlord's Address ____________________________________________________ Phone __________________________ How long at current address ______________ If less than 1 year please list previous address and how long there ________________________ _________________________________________________________________________________________________________________ Please provide the following information about your household: Number of Adults ________ Number of Children _______ Ages of children ______________________ Who will be primarily responsible for the care (feeding, grooming, exercise and training) of your new pet? _________________________________________________________________________________________________________ How many pets do you have now: Dogs _______ Cats _______ How many pets have you had in the last 5 years _______ Please list any pets you now have or have had in the past. If more space is needed use additional sheet. |
| NAME | TYPE/BREED | AGE | SEX | FIXED? | WHY YOU NO LONGER HAVE |
| ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ Have you ever adopted an animal from a shelter? If yes, Where? __________________________________ When? __________________ Are your current pets up to date on vaccinations and other necessary vet care? ___________________________________________________ What veterinarian would have records (past/present)? _______________________________________________________________________ Which veterinarian do you plan to use? _________________________________________________________________________________ Do any members of your household have allergies? ______________ To what? _________________________________________________ Do you have any plans to move in the near future? _______ If at some time you do move, what will you do with your pet? ________________________________________________________________________________________________________________ How much time will this cat be alone (without human companionship) Hours ________________ Days a week _______________ Will your cat be allowed outdoors? ________________________ How often? _____________________________________________ Do you plan on declawing your cat? _______________________ front feet __________________ all four feet _________________ What will you do if your cat: urinates outside the litter box? _________________________________________________________________ A cat can live well over 10 years and requires a major commitment of time, kind of commitment at this time? ____________________________________________________________________________________ Are you interested in adopting a cat? ___________ or kitten? ___________ Up to what age? _______________ Color? ______________ Hair length? __________________ Sex? __________________ Any other specifics? __________________________________________ |
| By signing below, I certify that the information given is true and correct and I recognize that any misrepresentation of facts will result in my losing the privilege of adopting a pet. I also give my veterinarian permission to release any vet care records and information about my current and past pets. |
| Signature ____________________________________________________ Date _____/_____/_________ Signature ____________________________________________________ Date _____/_____/_________ |
