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Adoption Application Form

If you are in the military, please fill out our military application.

Please note that we at Pit Bull Rescue San Diego make every effort to make the best possible match between dog and human family. We pride ourselves in the fact that we get to know all the dogs in our rescue very closely. Sometimes, while you may be a fabulous pet owner, we will determine that the dog you have chosen might not be the right match for your current situation. If this is the case, we will try to suggest that you meet a different dog in our program that might fit your family better. Please be as honest as possible in order to help us help you make a match that will last forever. We reserve the right to refuse to adopt a dog to anyone.
Which dog are you interested in?

Of all the breeds you could have chosen from, why did you choose a this one?


What drew you to this particular dog?


About You

Name
Home Phone
Cell Phone
Address
City/State/Zip
County
Please note: we do not have the resources to adopt outside of San Diego County at this time.
If you are outside of our service area, we encourage you to help your own community by adopting locally.
Email

Driver's License #   Your Age

Are you the head of household?   Yes  No
Please note that we only accept applications from the head of household.
Name of Spouse/Partner

  If the relationship were to change, who would keep the dog?

References

Occupation
Employer
Work Phone
Address
City/State/Zip:


Personal Reference:

Phone


Vet:

Phone
Address:
City/State/Zip

Your Family

How many total people reside in your household?  

If you have children, what are their ages?

Who will be the dog's primary caretaker?

Do all members of the household want a pet?  Yes  No

Do any family members have asthma or allergies?   Yes   No

Do you currently own a pet?  Yes  No

Please provide species, ages, and sexes of other pets


If you are adopting this dog as a companion for your other dog, please provide us with some information about your resident dog(s)
Current Dog's Activity Level
1   2   3   4
( 1 being not active and 4 being exceedingly active )

Current Dog's reaction to new people
Friendly   Cautious   Protective   Aggressive
More info:

Current dog's Personality and Behavior Qualities
leash trained
crate trained
good in a car
lap pet
tries to escape
obedient
timid/shy
independent/aloof
eager to please
even-tempered
goofy
likes to swim
likes to fetch
likes toys
protective/territorial
predatory
playful
skittish
affectionate
intelligent
gentle


How would you classify your current pet's social skills with other dogs  
Good with all dogs
Good with some dogs
Good with active dogs
Good with calm dogs
Good with females
Good with males
Good with larger dogs
Good with smaller dogs
Has not met other dogs
Has not met other dogs in their home


Other info we should have about your current dog to help us place the correct match in your home:



Are all current pets spayed/neutered?  Yes  No

If any of them are not spayed/neutered, would you consider that as a condition of adoption?  Yes  No

Have you previously owned a pet?  Yes  No

If no longer with you, what happened to him/her? (If passed away, please give circumstances)


Your Home

How long have you lived at your current address?

If you live in an apartment condo, what is the weight limit?

Do you rent or own your home?  Rent  Own

If you rent, please provide us with contact information for your landlord.
We will contact your landlord as a condition of approval.



IMPORTANT: Many homeowner's insurance companies have breed blacklists which include, but are not limited to, pit bulls, American Pit Bull Terriers, American Staffordshire Terriers, 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 submitting this application to adopt a pit bull type dog.

Landlords may also have these same breed restrictions due to their insurance policies. Please check this out before applying to adopt one of these breeds.


I have confirmed that my landlord or insurance policy does not breed restrict: Yes  No

Do you have a yard?  Yes  No

Is the yard fenced?  Yes  No  N/A

  If yes, what type of fence?   

  If yes, approximately, how high is the fence at the lowest point?  

Do you have a pool?  Yes  No

  If yes, is there a fence around the Pool?  Yes  No  N/A

Your Lifestyle

Why are you considering adding a pet to your life? (Check all that apply)
Companion for Children
Working Dog
Protection for Home/Family
Companion for other pets
Companion for Adults only
Other:

If you checked the 'Protection for Home/Family' box, please explain:


Will you be giving this dog as a gift?  Yes  No

Is the recipient of the gift aware or your intentions?   Yes  No

Where is your pet going to be when you are home? (Check all that apply)
Dog will be a house pet, living inside with the family
Dog will live in the basement or garage primarily
Dog will live outdoors primarily
Dog will live in a fenced dog run with a dog house
Dog will have a job as a guard dog for: Business    Residence
If you checked the 'Guard Dog' box, please explain the nature of the dog's responsibilities:

Other:

On average, how many hours per day will your pet be left alone?

When home alone dog will be (check all that apply):
In a crate, wire crate or dog pen inside
In an enclosed kennel outside
Tied up outside: On a cable run   With a chain
Dog will be loose indoors
Dog will be loose outdoors
Other:

How do you plan on keeping your pet exercised? (check all that apply)
Leash walks every day
Will have cable or dog run in the yard
Will be free to run in fenced yard
Will have supervised access to unfenced yard
Will be free to roam around (Off leash and unsupervised in unfenced area)
Will bring to dog park (Public area where dogs run & play together off-leash)
Other:

Describe what kind of training you will provide for your pet.


Under what circumstances would you need to give up your new dog? (Please check all that apply):
I would not be able to keep my dog if the following possible Personal Changes came upon me
Divorce / Separation
Disability / Illness
Moving
New Spouse/Partner
Pregnancy / Baby
New Roommate
New Allergy
Job Change / Loss
New Carpet / Furniture

Other:

I would consider returning my dog due to the following possible Behavior Problems
Kids too rough with dog
Dog too rough with kids
Does not get along with other pet(s)
Soils inside the house
Digs/chews/damages property
Needs too much attention/time

Other:

I would need to return my dog if they developed the following possible Health Problems
Dog incurs expensive vet bills
Requires daily treatment
Needs special diet
Dog becomes disabled
Other: 

Do you plan on taking your new dog to Obedience School? Yes  No

Have you ever been in a situation where you were not able to keep a pet? Yes  No
If Yes, please explain:


Were you ever in a situation where you had to bring a dog to the shelter? Yes  No
If Yes, please explain:


Do you travel often? Yes  No
Who would take care of your pet while you were away?


Who would you give the dog to if you moved?

There are a lot of true and false statements made about Pit Bulls in the media. What are some truths that you know about the breed??

Is there any other information you feel we should know about you?

Liability Release

Pets are an investment of your time and money. Are you prepared to provide medical care, grooming, proper diet, proper shelter and exercise for your new pet?
Yes  No

Do you understand that if arrangements don't work out with your new pet, you must be willing to return it to Pit Bull Rescue San Diego and that there will be no refund of your adoption fee after 3 days?
Yes  No

Please note that when PitBull Rescue San Diego rescues a dog, they rescue that dog for life. If we ever find that you have knowingly neglected any of the basic necessities for your dog as defined by California Law, we have the right to request that you return the dog to our care.

By checking YES you agree to absolve PBRSD and all of its representatives from any liability in reference to a dog featured in this web site.
Yes  No

By checking YES you agree that the dog will not be used in any illegal activities nor be found at any time in a municipality where Pit Bull presence is illegal.
Yes  No

By checking YES you agree that the dog is to be kept as a house pet (living primarily inside the home). It shall not be sold for medical or experimental purpose, and it shall not be used for breeding.
Yes  No

By checking YES you agree to the obedience training of this dog.
Yes  No

I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions can result in the application being declined. Also, if an omission or untruth is discovered after the adoption takes place, I understand and accept that PBRSD has the right to annul the adoption and reclaim the dog.

Yes  No

  

Thank you for choosing rescue as a means towards adding a new family member to your life. We will review your application and respond to you within 48 hours.