ALL ADOPTIONS AND FOSTER HOMES WILL BE FINALIZED THROUGH A LEGALLY BINDING CONTRACT.

IF YOU ARE INTERESTED IN FOSTERING AN ANIMAL, PLEASE LIST FOSTER(DOG NAME) IN THE SPACE BELOW.

ATTENTION: IF YOU DO NOT HEAR FROM A VOLUNTEER WITHIN 48 HOURS, PLEASE EMAIL INFO@CBBR.INFO AS YOUR APPLICATION MAY BE LOST IN CYBERSPACE!

Today's Date:
Name of dog you are interested in adopting:
   
Name:
Date of Birth:
Social Security Number:
Spouse (Roommate) Name:
Date of Birth:
Social Security Number:
   
Address (Line 1):
Address (Line 2):
City:
State:
Zip Code:
County:
   
Driver's License Number:
Spouse Driver's License Number:
   
E-mail Address:
Spouse E-mail Address:
   
Home Phone: Please include the area code.
Work Phone: Please include the area code.
Cell Phone: Please include the area code.
   
Occupation:
Company Name:
Company Address:
   
Who do you live with?
Ages:
   
How many adults in the household?
   
How many children in the household?
   
Please provide the gender and ages of the children:
   
Do you rent or own?
Accommodation type:
If you rent, do you have your landlord's permission to keep a dog?
Can you provide a copy of your lease?
   
Landlord's Name:
Phone Number: Please include the area code.
   
How long have you lived at this address?
 
If under 2 years, please give your previous address:
Address (Line 1):
Address (Line 2):
City:
State:
Zip Code:
County:
   
Do you have a completely fenced yard suitable for a dog?
   
Do you have a kennel run?
   
Please describe the kennel run/fenced yard. Type, height and approximate size.
   
If no fenced-in yard, how will you handle your pit bull's/am staff's exercise and toilet needs?
   
Do you have a suitable dog crate?
   
How many hours a day will the pet be alone?
   
Who will be responsible for the care of this dog?
   
Why adopt a pit bull/am staff?
   
Is the dog for your family or a gift for someone else?
   
If the dog is a gift, please explain further.
   
Does the entire family want this breed?
   
If answering no, please explain who and why not:
   
Do you have visitors (human and/or animal) who come to you with whom the adopted dog will interact? Please give details.
   
Please describe your lifestyle (i.e. passive, active, etc.):
   
Do you have cats? Please give details.
   
Any other animals? Please give details.
   
What activites do you plan to do with your new pet?
   
Please provide the details of your regular veteranarian:
Name:
Address:
Phone Number: Please include the area code.
   
Will your dog be crate or cage trained?
   
Will you attend obedience classes with your new pet?
   
Are you prepared for chewing, digging, scratching, housetraining and/or other mischevious behavior?
   
How will you reprimand your dog?
   
It may take several months for your new pet to adjust to it's new home. How will you handle this?
   
Do you have the time, patience and physical ability to exercise a large dog?
   
Are you prepared for the close personal attention this breed requires?
   
Are you willing to commit to owning a dog for the next 10-16 years?
   
Color preference:
   
Preferred age:
   
Preferred gender:
   
Ear preference:
   
I would be willing to consider a dog of a different:
   
How did you hear about us?
   
Please provide 2 family members who will know your whereabouts for the next 5 years.
Name #1:
Address:
Phone: Please include the area code.
Relationship:
   
Name #2:
Address:
Phone: Please include the area code.
Relationship:
   
Please provide the names of 2 character references.
Name #1:
Address:
Phone: Please include the area code.
Relationship:
   
Name #2:
Address:
Phone: Please include the area code.
Relationship:
   
Is there any other information you would like to add? Please use the text field below.
   
The information gathered on this questionnaire will be kept confidential. I certify that all information provided is complete and correct to the best of my knowledge.