Name of Animal Wanted______
CHELSEA BAILEY BUTTE-SILVER BOW ANIMAL SHELTER
PEOPLE AND DOGS PROFILE
“A dog is the only thing on earth that loves you more than it loves itself”
______Josh Billings
Date ______Shelter Employee ______
The information you provide will help us help you find the best match for you and family.
Please fill out application completely
YOU AND YOUR FAMILY
Adoption is a very serious commitment of your time and money. We take adoption very seriously as should you! It will alter your life as well as the dog’s life. Are you very certain you are ready and responsible enough to take care of another life? Yes No
Please list all adults living in the house-hold
Name ______Are you 18 years or older? Yes No
Name ______Name ______
Street address ______City ______State ______Zip ______
Home phone ______Place of work ______Work phone ______
Email ______
Type of housing (check all that apply): Own Rent Live with parents Military
House Condo Apartment Mobile
Length of time at current address: Months ______Years ______
Landlord name ______Phone ______
Name of friend or relative not living with you ______Phone ______
Veterinarian Reference (past or present)______Phone______
Name Vet. Account is under ______
Adults living in the household: Men, how many? ______Women, how many? ______
Children living in the house hold: Boys, how many? ______Ages: ______
Girls, how many? ______Ages: ______
Is there anyone in the household allergic to pets? Yes No Explain ______
Is there anyone in the household nervous or unsure of dogs? Yes No Explain ______
Do you have children in the neighborhood that visit? Yes No Ages: ______
Per Butte-Silver Bow Ordinance 6.04.292 and 6.04.150 all dogs and cats in BSB are required to have a current rabies vaccination, and all dogs residing in BSB are required to have a county dog license.
In accordance with BSB ordinances the animal shelter will require proof that all current pets in your home are current on a rabies vaccination and that the dogs have a current county license. The shelter is happy to obtain this information for you, please be sure to list what veterinary clinic the vaccinations were given for each animal and the name on the account.
PET HISTORY - EXPERIENCE
Current Pets
Type Name Age Sex Spayed/Neutered Where is the pet kept?
1. ______Yes No In Out Both How long have you owned this pet? ______
Current rabies vaccination?______If a dog, current county dog license?______
Veterinary Clinic and name on acct:______
2. ______Yes No In Out Both How long have you owned this pet? ______
Current rabies vaccination?______If a dog, current county dog license?______
Veterinary Clinic and name on acct:______
Past Pets
Type Name Spayed/Neutered Where was the pet kept? How long owned?
1. ______Yes No In Out Both ______
What happened to this pet? ______
2. ______Yes No In Out Both ______
What happened to this pet? ______
What’s your dog experience? First-time owner Have had one or two Knowledgeable & Experienced
Why do you want to adopt this dog? ______
What will you do with the dog when you leave town? ______
What will you do with the dog when you move? ______
If traveling with me, the dog would be: Inside the car Back of pick-up truck Crate
None, would stay home
If the dog becomes sick or injured will you take it to the vet immediately? Yes No Depends
When I relate to dogs I tend to be: Strict, demanding, a real leader (dog sits for treat)
Lenient, (dog gets treat because they’re cute)
Demanding or lenient, depending on the dog and situation
Will you be crate-training the dog? Yes No
If you returned home to find that the dog had chewed your favorite shoes or urinated on the floor what would you do? ______
If the dog needs professional training, are you willing and financially able to enroll the dog in a group class or with a private in-home trainer? Yes No
Who will be the primary care-taker of this dog? ______
Have you ever been denied at another Animal Shelter Yes No If so, what shelter and circumstances:
______
YOUR HOUSEHOLD
Time away from the animal: Home all day Out part-time Away 7 – 10 hours daily
Where will the dog be kept during the day? ______At night: ______
Where will the dog be kept when you are not at home? ______
Household activity level: Quiet Active Very active
Availability to exercise the dog: Minimal exercise during week/lots of exercise on weekends
Would go running daily with me
Long morning and evening walks
Three 15-minute walks a day
Do you have a fenced yard? Yes No (please be honest, if you don’t have a fenced yard it’s o.k., certain
dogs definitely need a fenced yard.)
If yes, type of fencing ______How high?______Is it secure? ______
Do you have a kennel or run? Yes No Is it covered? Yes No
Do you plan on having a tie-out or cable run for the dog? Yes No If yes, type ______
HOPES AND EXPECTATIONS
Breed Mix/Name ______Color/s ______
Size: 0-10 lbs 10-30 lbs. 30-55 lbs 55-85 lbs. 85-100 lbs. 100 & Up
Age: 8-16 weeks 4-12 months 1-3 years 3-7 years 8 & Up (Seasoned veterans, like Albert)
Coat: Short Medium Long No preference
Sex: Male Female No preference
Temperament and Activity level (check all that apply)
Zippy, high energy, puppy like Mellow, easy going
A lap dog Very affectionate
A total kissy face Responsive
Independent Vocal, talkative
Quiet Likes kids
Protective Special needs
Other: ______Likes other animals, Type ______
Training: Has none Is housebroken Has some obedience training Is fully trained
I prefer a dog whose energy level is: High Medium Low Couch potato
I prefer a dog that: Will enjoy with me on leash Will enjoy with me on or off leash
Will run, jog or hike with me Will exercise itself in our yard
Requires only enough exercise to do its “business” outside
Reason for wanting this dog: (check all that apply) Gift Watchdog Companion
Companion for other pet Worker
Hunter Other: ______
What personality traits are you looking for in your dog? ______
______
Dog habits I just can’t tolerate are: ______
______
I would like more information about: ______
Example: dog to dog intro, housetraining, crate-training, identification, vaccinations etc.
It sometimes takes a dog longer to adjust to a home that already has resident kids, dogs and cats. In some cases the new dog and other animals may never bond, only tolerate each other. How will you handle this? ______
RELEASE AND AGREEMENT
I certify that the information I have given is true, and I authorize the CBBSB Animal Shelter to contact veterinarians, landlords and references to investigate all statements in this application, and to do follow-up property checks.
Signature ______Date ______