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Adoption Application
All questions on this application are required to be answered for submission. If you have no reply or the question does not apply please enter "N/A" for a response.
Thank you
First Name:
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Last Name:
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Spouse/Partner Name:
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Address:
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City:
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State:
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Zip:
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Phone Number:
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Work Phone:
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Cell Phone:
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Fax:
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Email:
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Text/Pager Email:
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Alternate Email:
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Which dog are you applying for (Give the name and state):
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Have you been in touch with the person listed as the contact:
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If you are interested in more then one dog, please list them here:
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Would you prefer a male or female:
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What age range are you looking for in a dog:
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What is the best time and method to reach you (Phone, email, day, evening):
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How many adults-age 18 and over-live in this home? Do they all agree they want to adopt a dog:
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How many children (If any) are in the home? What are their ages:
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Have you ever adopted from ABR before? IF so, when:
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How did you hear about us:
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If you have ever adopted from another rescue group and couldn't keep the dog, did you return it to the group? Please explain further:
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List your current LIVING pets. Please include their breed, age, and gender if they are spayed or neutered and if they are kept indoors or outdoors. PLease do not omit and of this information:
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If your current pets are not spayed/neutered, please explain why:
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Have you ever given up a pet? If yes, please explain:
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Have you ever taken an animal to a pound or shelter? If yes, please explain:
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What traits are you looking for in a Brittany? Companion, hunter, service dog, couch potato, good citizen, etc:
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Expected activity level:
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In what type of home do you live:
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Single Family
Duplex
Apartment
Townhouse
Condominium
Mobile Home
Military Housing
If you rent, have you received the approval of your landlord to have an animal:
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If you rent please enter your Landlord's name and phone number:
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Is you yard fenced:
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Yes
No
What type of fence:
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None
Privacy Fence
Chain Link Fence
Invisible
Other
What is the height of the fence:
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Have you ever used a crate with a dog before? Please explain:
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Will your Brittany be living indoors with the family:
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How much time will the animal spend alone at home:
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Where with the animal sleep:
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Where will the animal be kept when you are home:
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Where will the animal be kept when you are not home:
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Describe how you will train the pet:
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Have you ever taken a dog to an obedience class before:
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What circumstances do you feel justify giving a dog up? ( select all that apply)
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Moving
New baby
Divorce
Doesn't get along with other pets
Get's out of fence
Children lost interest
Behavioral problems
Dog has become too big
Too time consuming
Shedding
Allergies
Housebreaking issues
Aggressive behavior
Animal's medical issues
Death
Other
None
Please explain further what circumstances would cause you to give up your dog:
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If you have or had any pet's, please list the Veterinarian's names and phone number:
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List at least two references, please include full contact info:
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Why are you interested in adopting a Brittany at this time?
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Have you applied with any other rescues? If so, which ones:
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If you have any further questions or comments, please include them here:
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