Rescue-A-Bull Pit Bull Rescue

“North Alabama, Tennessee Valley, Bully Breed Rescue”

Adoption Application
Contact Information
First & Last Name:
Occupation:
Address:
City, State, & Zip Code:
How Long at this Address?
Daytime Phone:
Evening Phone:
Best Time to Call:
Email Address:
Family & Housing
How many adults are there in your family? (Their relationship to you & ages)
How many children? Ages?
What type of home do you live in?

Single Family Town Home Apartment Farm
Please describe your household:

Active Noisy Quiet Average
If you rent, please give the rules governing pets and the landlord's name and number. By providing this information to Rescue-A-Bull, you are allowing us to contact your landlord. Please inform them of this call so that they will speak with us.
Does anyone in your family have a known allergy to dogs?

Yes No
Is everyone in agreement with the decision to adopt a dog?

Yes No
Do you have time to provide adequate love & attention to a dog?

Yes No
Other Pets
What other pets do you have? Specify type & number)
Are these pets up to date on vaccines?

Yes No
Are these pets spayed/neutered?

Yes No
If not, why?
Have you ever surrendered a pet to a rescue or shelter?

Yes No
If so, why?
Have you ever had a pet euthanized (put to sleep)?

Yes No
If so, why?
Have you ever lost a pet to an accident?

Yes No
If so, what kind? How?
How do you discipline your pets and why?
Veterinarian
Do you have a regular veterinarian?

Yes No
Veterinarians Name:
Clinic Name:
Clinic Address:
Clinic Phone:
A veterinary reference is required for you to adopt one of our animals. Do you agree to allow Rescue-A-Bull to check with your veterinarian on the status of your current pets? Please notify them that we'll be calling.

Yes No
About the Dog You Wish to Adopt
What is your idea of an ideal dog & why?
Desired age:

0-6 months (Puppy) 6 months-1 year 1 year-2 years 2 -4 years 4-6 years 5-7 years 7+ years (Senior)
Desired size:

Small Medium Large Extra Large
Desired Breed:

Pit Bull/Am Staff Pit Bull/Am Staff Mix American Bulldog Boxer Other No Preference- Any Bully Breed
Desired Sex:

Spayed Female Neutered Male No Preference
Willing to Adopt:

Outgoing/Hyper Dog Dog that Needs Regular Medication Dog that needs Grooming Shy and/or Nervous Dog Dog that Needs Training None of These All of These
Where will the dog spend the day? Describe.
Where will the dog spend the night? Describe.
How many hours will the dog spend alone per day/week?
Who will have responsibility for the dog's daily care?
Who will have financial responsibility for the dog?
Who will discipline the dog?
Do you agree to provide regular health care by a Licensed Veterinarian?

Yes No
Do you agree to keep the dog as an indoor dog?

Yes No
When the dog goes out, how do you plan to supervise it?
Do you have a fenced yard?

Yes No
What type of fence do you have?

Partial fencing 4-foot Chain Link Fencing 5-foot Chain Link Fencing 6-foot Chain Link Fencing Stockade Fencing Privacy Fence Chicken Wire Fencing
Do you agree to contact Rescue-A-Bull if you can no longer keep the dog?

Yes No
A home visit is required to adopt one of our dogs. Do you agree to allow a representative of Rescue-A-Bull to visit your home?

Yes No
Would you be interested in fostering?

Yes No
How did you hear about Rescue-A-Bull?
Personal References
Name, Address, Phone & Relationship (Relative, Neighbor, Friend, etc) of Reference # 1.
Name, Address, Phone & Relationship (Relative, Neighbor, Friend, etc) of Reference # 2.
Name, Address, Phone & Relationship (Relative, Neighbor, Friend, etc) of Reference # 3.
In consideration for placing the animal with me, I agree to release, discharge, indemnify, and hold Rescue-A-Bull harmless for any and all damage caused by a Rescue-A-Bull animal, directly or indirectly, to myself, my personal property or pets while performing any and all duties as an adoptive parent.

Agree Disagree
All the information I have given is true & complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affectional, and annual physical examinations & vaccinations by a Licensed Veterinarian. By signing here, electronically, I agre to all of the above. Please provide your electronic signature and the date.
Should be Empty:

Rescue-A-Bull Pit Bull Rescue

“North Alabama, Tennessee Valley, Bully Breed Rescue”

Adoption Application

Contact Information

Family & Housing

Other Pets

Veterinarian

About the Dog You Wish to Adopt

Personal References