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Adoption Application

We are happy that you have come to us to adopt a dog/puppy. We hope that we can be of service to you. To help ensure that the animal you want will be best suited to you, your home and lifestyle, and that the animal will be placed in an environment compatible with its needs, we ask your cooperation in filling out the application. We hope you will agree that the animal’s welfare MUST be our foremost consideration. Upon completion of this application, a staff member will discuss the adoption with you and answer any questions you might have. We ask for your patience and cooperation. Thank you.

Click Here to Download our Adoption Application

or Fill out the online adoption form below

Which of our dogs are you interested in: *

Name* Age Driver's License

Co-Applicant Name Age Driver's License

Street Address

City County State Zip

Mailing Address (if different from above)

Your Email* Home Phone Cell Phone

Work Phone Occupation

Who will be responsible for this animal?

Do you live in a:  House Apartment Duplex Mobile Home Other

Do You:  Own Rent Live with parents, relative or guardian

If renting, does your landlord/rental allow pets?  yes no

Landlord's Name: Landlord's Phone Number

How long have you lived at your current address?

Do you anticipate moving in the next 6 months?

If you move sometime in the future, what will you do with your pets?

Do you have children at home?  yes no

Ages?

Are they used to animals?  yes no

Is anyone allergic to animals?  yes no

Do all adult members of your household know that you plan to adopt a dog?  yes no

Why do you want this animal? (please select one or more of the following)
 Guard Dog Companion for the kids Watch Dog Hunting Dog Companion for other dog/Puppy For Breeding Stock Dog Gift Other

If other, please explain:

Do you have other animals at home?  yes no

How Many?

Kind of Pet            Name                                    Sex                 Age        Time Owned       Spayed/Neutered




Are all your pets current on their vaccinations?  yes no

What is the name of your veterinarian/clinic?

How many hours a day will this pet be alone? (without human companionship)

Where will this dog be during the day?

And at night?

Will this dog be allowed indoors?

Where will this dog sleep?

When this animal is outside, will it be:
 In a fenced yard on a leash allowed to run loose on a trolley chained other
If other:

If the yard is fenced, will it safely confine this animal? yes no

Type of fence Height

What kind of Shelter will be provided?

Are you willing to roll this dog into obedience classes?  yes no

Are you aware of your local animal control regulations?  yes no

Is your dog licensed? yes no Will you license this dog?  yes no

How many pets other than the ones previously listed, have you owned in the last 5 years?

What happened to them?

Would you allow our representative to see this animal in it's new home?  yes no

Are you aware of the financial commitment and responsibilities of owning a companion animal? (Approximately $600 a year or more for basic necessities)  yes no

Are you willing to spend this much or more?  yes no

REFERENCES One reference must be a veterinarian. Other references may include neighbors or co?workers.
Name: Relationship: Phone Number:
Name: Relationship: Phone Number:
Name: Relationship: Phone Number:

By checking the agreement box below, I certify that the information I have given is true and that any misrepresentation of facts may result in my losing the privilege of adopting a companion animal from BullyWag, Inc. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection and medical care. I am in full agreement with these terms of adoption. BullyWag, Inc. is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog in my household.
 I agree I do not agree

BullyWag, Inc. reserves the right to refuse any applicant!