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Order Number

Applicant Information

Last Name: *

First Name: *

Middle Initital:

Birth Date: (mm/dd/yyyy) *

Address: *

City: *

State: *

Zip Code: *

Primary Phone Number: *

Best Number to Reach You At

Secondary Phone Number:

Another Number At Which You Can Be Reached

What is the best time to call you?

Let Us Know When to Contact You

Email Address *

How do you prefer to be contacted? *

By Phone

By Email

Animal Information

Is this application for a dog or a cat? *

Dog

Cat

What's the name of the dog or cat you're interested in adopting?

Why does this dog or cat interest you?

Family Dynamics

Please list the full names and birth dates of any other people in the household.

First Name:

Middle Initial:

Last Name:

Birth Date: (mm/dd/yyyy)

Relationship to Applicant:

Is there anyone else in the household?

Yes

If you do not have small children living in your home, will your rescued pet come into regular contact with any children?

Yes

Has anyone in the household ever been convicted of domestic battery, animal cruelty or a violent crime? *

Yes

Are you willing to allow a representative visit your home before and after adoption? *

Yes

Do you own, rent or live with relatives? *

Own My Home

Rent My Home

Live with Relatives

What type of residence? *

Single Family House

Apartment

Condo

Townhouse

Other

How long have you lived at your current address? *

If you've lived at your current address less than 7 years, please provide ALL previous addresses that you've lived at in the past 7 years:

If you ever move into a building/house that did not allow pets, do you understand that you are required to return your pet to BAWF?! *

Yes

If you ever move out of state and could not take your pet with you, do you understand that you would be required to return your pet to BAWF?! *

Yes

Environment

Do you work full-time? *

Yes

Do you work part-time? *

Yes

Are you retired? *

Yes

Is anyone in the household a stay-at-home person? *

Yes

How many hours will your pet be left home alone? *

Describe where your pet will be when you're home: *

Describe where your pet will be when you're not home: *

Describe where your pet will be when you're asleep: *

Will your pet be an inside or outside pet? *

Inside Pet

Oustide Pet

When outside, where will your dog be? (check all that apply) *

loose in fenced yard

leash walked

tied / chained on porch

tied / chained in unfenced yard

dog run

dog house

N/A, this application is for a cat!

Do you have a fenced in yard? *

Yes

Current & Past Pets

Please tell us about your most recent (current and past) pets. Please include the type of pet, breed, size, gender, age, whether or not it is/was spayed/neutered, whether your still own the pet, and if you no longer own the pet, where is the pet now?

If this application is for a dog, please describe the type of dog collar you are using with your current dog(s) or what type of collar you plan on using with your newly adopted dog (e.g. link chain, buckle, nylon snap, pinch/prong, harness, e-collar, etc...):

Are your current dogs heartworm tested annually? *

Yes

I currently don't have a dog.

Are your current dogs kept on a heartworm preventative? *

Yes

I currently don't have a dog.

If you do not have a dog currently, were any previous dogs heartworm tested and kept on a heartworm preventative? *

Yes

I have not owned a dog before.

Who is your current veterinarian?

Current Veterinarian Phone Number:

Names of the pets seen by your current veterinarian:

Have you ever had to give up a pet? *

Yes

Have you ever had a pet lost, stolen or hit by a car? *

Yes

If this application is for a dog, how do you plan to discipline the dog? *

If this application is for a dog, what is your anticipated level of exercise with the dog? *

couch potato

yard exercise

short walks

dog parks

vigorous walks

hiking

jogging

References

Please provide 3 non-family personal references that are familiar with your family and pets.

One reference should be a neighbor.
Please provide phone numbers.
References can include pet sitter, groomer, etc...
Please do NOT include your vet or family members.

Reference #1 Name: *

Reference #1 Phone Number: *

Reference #1 Relationship: *

Reference #2 Name: *

Reference #2 Phone Number: *

Reference #2 Relationship: *

Reference #3 Name: *

Reference #3 Phone Number: *

Reference #3 Relationship: *

Certify & Submit

A pet you adopt today will likely be part of your family for the next 12 to 15 years.

For those of you applying to adopt a dog... A dog makes considerable demands on your time and resources. As a dog owner, you will need spend time training, socializing, grooming, feeding, scooping poop, exercising and playing with your dog each day. Dogs that have not had training need even more time and socialization. All dogs require regular medical care. Some dogs require special food or medications. Some dogs require regular professional grooming.

When adopting either a dog or a cat, keep in mind that vet bills, pet sitting and vacation boarding fees may add considerable expense. All applicants need to be prepared to accept the personal and financial responsibility of owning a rescued dog or cat.

I certify that I understand adopting a pet is a serious responsibility.

Yes, I understand.

I certify that the information provided on this application is true, and I recognize that any misrepresentation of facts will result in losing adoption privileges. I further understand that the adoption of this pet may be delayed until information can be verified.

Yes, I certify.

I authorize investigation of all statements in this application, understanding that veterinarians, landlords and personal references may be contacted, and I authorize the persons/entities listed above and/or their personnel to disclose to a representative of BAWF information that they possess regarding myself, my family, and the treatment and services of my current or former pets.

Yes, I authorize.

I understand that the information BAWF receives during the approval process is confidential and that BAWF cannot give details to me, the applicant, if my application is denied.

Yes, I understand.

I affirm that typing my name and today's date in the fields below and clicking the *

Yes, I affirm.

Applicant's Full Name:

Today's Date: (mm/dd/yyyy) *

BAWF Adoption Application

Environment