Adopt

Adoption Application

Ready to make one of our pups part of your family? Complete the application below or print, fill out and submit the downloadable .pdf and we will be in touch!

Download the Printable Version

Adopt

This application is the first step of the adoption process. Please provide complete and accurate information. The time necessary to verify information and process this application will vary.

***Filling out an application does not guarantee approval to adopt.***

You must be at least 21 years old to adopt an animal from Bubbas Station Rescue. You will need to provide your current identification showing your current address.

Name of dog you wish you adopt: *

Today's Date *

APPLICANT INFORMATION

Name *

Name

First

Last

Primary Phone *

Email *

Date Of Birth *

Address *

Address 1

Address 2

City *

State *

Zip/Postal Code *

Country *

Length of time at this address:

Employer *

Occupation *

Length of time at current employer: *

Work Schedule (Be Specific): *

RESIDENCE INFORMATION

Do you own a home, rent a home, or live with family? *

If "Rent," provide Landlord/Management's name & contact information:

If "Rent," provide any animal, breed, weight, or size restrictions:

Do you have an HOA/Community Association Co? *

Yes

If "Yes," to HOA/Community Association Co, please provide name & contact information:

What type of home do you live in?

If "Other," type of home please explain:

If Apartment:

Do you have a fenced-in yard? *

Yes

If "Yes fenced-in" please describe type of fence:

Size of yard?

Large

Medium

Small

Do you have a swimming pool?

Yes, In Ground

Yes, Above Ground

Do you have any plans to move in the next 12 months? *

Yes

HOUSEHOLD INFORMATION

Name(s) & age(s) of all other adults living in the household: *

Name(s) & age(s) of all children living in the household. Please include children living part-time or weekends *

Do all members of the house agree to adopt? *

Yes

Is anyone living in the home allergic to animals? *

Yes

Unknown

Who will be the primary caregiver of this dog? *

Who will be the primary caregiver of this dog?

First

Last

Will you use a crate? *

Yes

Will the dog be outdoors? *

Yes

If "Yes, the dog will be outdoors" please check all that apply:

Supervised

Unattended sometimes

Unattended most of the time

On a tether or a chain

On a leash

In an enclosure

In a fenced yard

In a garage

Which best describes the activity level of your household? *

Very active, frequent visitors

Moderately active

Quiet, low-key

What is your preferred level of energy/exercise when it comes to a dog? *

Couch potato

Short walks

Long or vigorous walks

Hiking or jugging/running

Ready for puppy chaos

Puppy energy

Lapdog

On average, how many hours a day will the dog be left alone? *

On average, how many days per week will the dog be left alone? *

Where will the dog spend their time when you are not home? *

Free to roam

In a crate

Gated in an area

Inside a closed room

Garage

Basement

Outside

What areas of the home will the dog be allowed into?

What areas of the home with the dog NOT be allowed into?

Will the dog be allowed on furniture?

Yes, all of it

Yes, some of it

Where will the dog be kept at night? *

Free to roam

Crated

Inside a closed room

In my bed

Wherever the dog wants to sleep

Garage

Basement

Outside

Other

Where will the dog be kept at night? If "Other," please explain:

What might make you give up a pet? Check all that apply. *

Divorce

Illness in the family

Moving

New baby

New job

Housebreaking problem

Chewing

Barking

Shedding

Dog becomes ill

Pets didn't get along

Dog showed aggression

Other

Would never give up a pet

How long are you going to allow the new pet to adjust to his or her new home? *

Rescue dogs may have behavioral or health issues due to their history. Are you willing to work with the pet extensively to help them overcome any problems during their adjustment time to your home? *

Yes

If the animal gets lost, what will you do?

Are you willing to enroll the dog in obedience class if needed?

Yes

CURRENT & PAST PET INFORMATION

Do you currently have any other pets in your household? *

Yes

Yes, but they are not mine

If "Yes," please complete all of the remaining questions in this section.

Name & phone number of your veterinarian:

*Please contact your veterinarian's office to give permission to release records*

Pet #1 - Type Of Animal/Name

Pet #1 - Breed

Pet #1 - Age

Pet #1 - Amount Of Time Living With You

Pet #1 Neutered/Spayed?

Yes

Pet #1 - Up-to-date On Vaccines?

Yes

Pet #2 - Type Of Animal/Name

Pet #2 - Breed

Pet #2 - Age

Pet #2 - Amount Of Time Living With You

Pet #2 Neutered/Spayed?

Yes

Pet #2 - Up-to-date on Vaccines?

Yes

Please include information for any additional pets still living with you:

Please list any pets that you have had within the last 5 years. Include name of pet, type, & amount of time living with you:

Reason pet(s) are no longer living with you:

Are you financially able to provide annual check-ups and vaccines? *

Yes

PERSONAL REFERENCES

*Please provide 2 personal references that are not related to you*

Reference #1 *

Reference #2 *

Have you applied to another rescue or shelter?

Yes

If approved by another shelter, please list name:

Have you ever given up an animal?

Yes

If "Yes," (you have given up an animal) please explain why & where the animal went:

If your dog/pet were to survive you, what would happen to them? *

Who would assume responsibility of the dog? Is this person aware of this and in agreement? *

Please provide any additional information about yourself, your past experience with dogs, and why you feel you could provide a good home for a rescue animal:

Once we deem our dogs ready, applications are accepted to their Furever home! We do not hold dogs once an application is approved. Is there anything that would prevent you from taking your dog to their new home right away? (ie moving, vacation, visitors, travel, home renovations, not quite ready) *

Yes

If "Yes," please explain:

EMERGENCY CONTACT INFORMATION

Name *

Name

First

Last

Email *

How did you hear about Bubbas Station Rescue?

By typing or signing my name and submitting this form, I agree that all information provided is true & correct to the best of my knowledge. I understand that any misrepresentation may result in Bubbas Station refusing adoption privileges to me. I authorize a representative of Bubbas Station to contact any veterinarian references listed as well as my current landlord, if applicable. *

By typing or signing my name and submitting this form, I agree that all information provided is true & correct to the best of my knowledge. I understand that any misrepresentation may result in Bubba's Station refusing adoption privileges to me. I authorize a representative of Bubba's Station to contact any veterinarian references listed as well as my current landlord, if applicable.

First

Last

CAPTCHA

If you are human, leave this field blank.

Adopt

This application is the first step of the adoption process. Please provide complete and accurate information. The time necessary to verify information and process this application will vary.

***Filling out an application does not guarantee approval to adopt.***

You must be at least 21 years old to adopt an animal from Bubbas Station Rescue. You will need to provide your current identification showing your current address.

Name of dog you wish you adopt: *

Today's Date *

APPLICANT INFORMATION

Name *

Name

First

Last

Primary Phone *

Email *

Date Of Birth *

Address *

Address 1

Address 2

City *

State *

Zip/Postal Code *

Country *

Length of time at this address:

Employer *

Occupation *

Length of time at current employer: *

Work Schedule (Be Specific): *

RESIDENCE INFORMATION

Do you own a home, rent a home, or live with family? *

If "Rent," provide Landlord/Management's name & contact information:

If "Rent," provide any animal, breed, weight, or size restrictions:

Do you have an HOA/Community Association Co? *

Yes

If "Yes," to HOA/Community Association Co, please provide name & contact information:

What type of home do you live in?

If "Other," type of home please explain:

If Apartment:

Do you have a fenced-in yard? *

Yes

If "Yes fenced-in" please describe type of fence:

Size of yard?

Large

Medium

Small

Do you have a swimming pool?

Yes, In Ground

Yes, Above Ground

Do you have any plans to move in the next 12 months? *

Yes

HOUSEHOLD INFORMATION

Name(s) & age(s) of all other adults living in the household: *

Name(s) & age(s) of all children living in the household. Please include children living part-time or weekends *

Do all members of the house agree to adopt? *

Yes

Is anyone living in the home allergic to animals? *

Yes

Unknown

Who will be the primary caregiver of this dog? *

Who will be the primary caregiver of this dog?

First

Last

Will you use a crate? *

Yes

Will the dog be outdoors? *

Yes

If "Yes, the dog will be outdoors" please check all that apply:

Supervised

Unattended sometimes

Unattended most of the time

On a tether or a chain

On a leash

In an enclosure

In a fenced yard

In a garage

Which best describes the activity level of your household? *

Very active, frequent visitors

Moderately active

Quiet, low-key

What is your preferred level of energy/exercise when it comes to a dog? *

Couch potato

Short walks

Long or vigorous walks

Hiking or jugging/running

Ready for puppy chaos

Puppy energy

Lapdog

On average, how many hours a day will the dog be left alone? *

On average, how many days per week will the dog be left alone? *

Where will the dog spend their time when you are not home? *

Free to roam

In a crate

Gated in an area

Inside a closed room

Garage

Basement

Outside

What areas of the home will the dog be allowed into?

What areas of the home with the dog NOT be allowed into?

Will the dog be allowed on furniture?

Yes, all of it

Yes, some of it

Where will the dog be kept at night? *

Free to roam

Crated

Inside a closed room

In my bed

Wherever the dog wants to sleep

Garage

Basement

Outside

Other

Where will the dog be kept at night? If "Other," please explain:

What might make you give up a pet? Check all that apply. *

Divorce

Illness in the family

Moving

New baby

New job

Housebreaking problem

Chewing

Barking

Shedding

Dog becomes ill

Pets didn't get along

Dog showed aggression

Other

Would never give up a pet

How long are you going to allow the new pet to adjust to his or her new home? *

Rescue dogs may have behavioral or health issues due to their history. Are you willing to work with the pet extensively to help them overcome any problems during their adjustment time to your home? *

Yes

If the animal gets lost, what will you do?

Are you willing to enroll the dog in obedience class if needed?

Yes

CURRENT & PAST PET INFORMATION

Do you currently have any other pets in your household? *

Yes

Yes, but they are not mine

If "Yes," please complete all of the remaining questions in this section.

Name & phone number of your veterinarian:

*Please contact your veterinarian's office to give permission to release records*

Pet #1 - Type Of Animal/Name

Pet #1 - Breed

Pet #1 - Age

Pet #1 - Amount Of Time Living With You

Pet #1 Neutered/Spayed?

Yes

Pet #1 - Up-to-date On Vaccines?

Yes

Pet #2 - Type Of Animal/Name

Pet #2 - Breed

Pet #2 - Age

Pet #2 - Amount Of Time Living With You

Pet #2 Neutered/Spayed?

Yes

Pet #2 - Up-to-date on Vaccines?

Yes

Please include information for any additional pets still living with you:

Please list any pets that you have had within the last 5 years. Include name of pet, type, & amount of time living with you:

Reason pet(s) are no longer living with you:

Are you financially able to provide annual check-ups and vaccines? *

Yes

PERSONAL REFERENCES

*Please provide 2 personal references that are not related to you*

Reference #1 *

Reference #2 *

Have you applied to another rescue or shelter?

Yes

If approved by another shelter, please list name:

Have you ever given up an animal?

Yes

If "Yes," (you have given up an animal) please explain why & where the animal went:

If your dog/pet were to survive you, what would happen to them? *

Who would assume responsibility of the dog? Is this person aware of this and in agreement? *

Please provide any additional information about yourself, your past experience with dogs, and why you feel you could provide a good home for a rescue animal:

Yes

If "Yes," please explain:

EMERGENCY CONTACT INFORMATION

Name *

Name

First

Last

Email *

How did you hear about Bubbas Station Rescue?

By typing or signing my name and submitting this form, I agree that all information provided is true & correct to the best of my knowledge. I understand that any misrepresentation may result in Bubba's Station refusing adoption privileges to me. I authorize a representative of Bubba's Station to contact any veterinarian references listed as well as my current landlord, if applicable.

First

Last

CAPTCHA

If you are human, leave this field blank.