Cedar Valley Pit Bull Rescue



Adoption Application

Please list the top 3 dogs that you are interested in:

______________

_______________

_______________

The Basics

Name: ____________________________________

Address: _____________________________________________________________

Own or rent? _________ Landlords name and phone number: ______________________

______________________

Phone number: ________________ Email: _________________

Birth Date:_______ How many adults live in the home? ________

Name and birth date for anyone over 18 years old that lives in the home:

______________________________________________________________

Age of the children that live in the home: ___________________________________

Animal Care

Are there any other animals in your home? If so please list the type, age, sex: ____________________________________

Are all of your animals altered? ____________

Any animals you've had previously that you no longer have? ________

If yes, please explain:___________________________________________________

Vet Reference: Name: ____________________ Phone number: _________________

How many hours a day will the dog be home alone? _________

When the dog is left alone where will it be? Check all that apply:

In a kennel _____

Left out to roam the house with other animals _______

Left out to roam the house by itself _______

In an outdoor kennel or fenced in yard _______

Dogs will live: (Mark all that apply)

As inside pets, with the family _____

Outside in a kennel ____

Do you live in a

Single family home _______

Apartment _______

Condo ______

Mobile home _______

How big is your yard?

Small ____

Medium _____

Large _____

Acreage _____

No yard _____

Do you have a fenced in yard? If so how high is the fence? Wood or chain link? ____________________________________________________________

Please tell us about your lifestyle so that we can find the best fit for your home. (ie. Very active, quiet and stay home, travel a lot, out doors a lot, etc.)

How will you exercise the dog? Check all that apply.

Leash walks everyday ______

Will have a cable or dog run in the yard ______

Will be free to run in fenced in yard ______

Will have supervised access to unfenced area _____

Will be free to roam around (unsupervised in an unfenced area) ____

Other: _________________________________________________

Besides your vet reference. Please give us the name and telephone number for two other references that are not related to you that can attest to your character:

___________________________________________________________________

___________________________________________________________________

Please continue to the next page.

Please answer the following questions in depth.

1. What experience do you have with this breed? Please also include any research you have done on your own and what you have learned.

2, It is important that all precautions are taken to ensure that your dog is never running around at large for many reasons. Can you ensure that the dog you are apply for will always be supervised when outside? He or she may be able to easily break a chain or get out of a fence if not supervised. Please share your thoughts.

3. Pit bulls, by nature, are very loyal dogs. They want to please their owners and learn best through positive reinforcement. When training, you will get better results through consistency and rewarding good behavior rather than punishing unwanted behavior. Are you aware of this and what are your thoughts?

4. Of all breeds available why do you want a pit bull?

5. Many things can change in life. How can you ensure that the dog you are applying for will be taken care of through all stages of life?

6. Some dogs can have high dog aggression and should not be taken to off leash dog parks because of this. We encourage dog socialization and play dates in a controlled environment with slow introductions. What are your thoughts?

7. How long are you willing to give the dog to adjust to being a member of your family? How are you going to help the dog with this adjustment?

8. Why would you be a good home for one our dogs?

IMPORTANT!!

Many homeowner’s insurance companies have breed blacklists which include, but are not limited to,pit bulls, American Pit Bull Terriers, American Staffordshire Bull Terriers, Rottweilers, Dobermans, Akitas, American Bulldogs, Chows and wolf-hybrids and will not insure you if they reside in your home or may cancel your insurance if you add a dog of these breeds to your home. Please check your homeowner’s insurance policy regarding breed discrimination BEFORE adopting/fostering a pit bull type dog. Landlords may also have these same breed restrictions due to their insurance policies.

Please read this information carefully before signing.

Cedar Valley Pit Bull Rescue is a volunteer based, nonprofit, organization that works hard to place the right dogs with the right families. We want our dogs to have great, forever homes. We do run background checks on all adults in the home and reserve the right to deny any application. We will also set up a time to do home check, once the application has been processed.

Each of our available dogs stays with a foster family while waiting to be adopted. This ensures that the dogs stay socialized and remain in a family setting. Even with foster homes it can still take some time for the dogs to settle into their new surroundings when they are adopted. In the first few days you may see some signs of stress from the dog. This can be very normal. We ask that you give the dog two weeks to feel comfortable and to adapt in your home. You may contact us at any time if you have any concerns or questions. We will gladly help. Once you have adopted the dog, if for any reason you cannot keep the dog, you must bring it back to Cedar Valley Pit Bull Rescue. Our adoption fees are based on the dog's vet bills and are considered a nonrefundable donation.

By signing you are agreeing to the above information and understand that filling out the application is not an automatic approval. We work very hard to make sure our dogs are placed in the right forever homes. We reserve the right to deny any application. We will contact your once your application has been reviewed. This typically takes 24-48 hours.

Signature: ___________________________ Date: _______________

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