ADOPTION APPLICATION

Applicant’s name ________________________________________________

Address _______________________________________________________

City, State, and Zip Code _________________________________________

Home phone number _______________________ Best time to call you _________

Cell phone number ______________________________________________

Home email address_____________________________________________

Place of employment_____________________________________________

How many hours per day will the dog be home alone? ___________________
Where will the dog stay when you are not home? ________________________

Do you own your home? ____________  Rent your home?_________________

If renting,  please give landlord’s name and phone number _______________

Do you have a fully fenced yard ?________________________________________
If yes, type of fencing: ____________________________________________ 

Please list the names and ages of all persons living in your household

List all animals living in your household with breed, age and indoor/outdoor pet

Are all pets in your home spayed or neutered?  __________
If not spayed/neutered, why not? __________________________________________

What type heartworm preventative do you use? __________________________

What type of flea and/or tick preventative do you prefer? ____________________

Why do you want to adopt a bichon?   What is there about the breed that attracts you? ________________________________________________________________________________ ________________________________________________________________________________

Does everyone in the family want a bichon? __________________________________________________

Please provide the names and phone numbers of three people who are unrelated to you that are familiar with your pet ownership history

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

 Please provide the name, practice name and phone number of your veterinarian

_________________________________________________________________

 Thank you for your interest in adopting one of our rescue fluffs.  If you are applying for a specific dog, please write name here: _________________________________

Please Note: Our goal in rescuing and re-homing animals is to provide them with a loving home for the rest of their life.  Your adoption donation covers part of the medical costs associated with the animal.   All animals adopted by our group will be spayed or neutered prior to permanent placement.  We are not able to make exceptions to this policy. In addition, all animals have received necessary vaccinations and been screened for intestinal and heartworms.  Your new animal will be on a heartworm preventative program and you agree to continue this treatment.  Your signature below states that you understand any future medical costs are your responsibility and we have made full disclosure regarding OUR KNOWLEDGE of the health of the animal. 

By signing below, you also agree that if FOR ANY REASON, you are no longer able to care for the animal, it is to be returned to Bichon Rescue Tennessee, Inc., New Market, TN  37820,  865-475-0878. 

Please be advised that our adoption contract allows us to reclaim ownership of the animal if you decide not to keep it in the original agreed upon conditions for maximum health and well being. All dogs must live IN your home. Our best efforts are made to ensure that the animals are compatible with the new owners.  Sometimes, for reasons beyond anyone’s control, the adoption does not work out.  In this case, the animal will be returned to us. 

______________________________________          ____________________
Signature of Applicant                                                      Date

_____________________________________          ____________________
Signature of Applicant                                                      Date
 

Please send application via email to:   application@brtn.org
or mail to:
BICHON RESCUE TENNESSEE, INC.
1623 Hodge Road
New Market, TN  37820