First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Can we text you at your cell phone number?

Please select your age range from the list below:*
Choose one: Under 21 year old 21-34 years old 35-44 years old 45-54 years old 55-64 years old 65-74 years old 75 years or older

Facebook Messenger ID

Occupation

Spouse's Name

Spouse's Occupation

Do you travel often?

If so, how many days a week?

If interested in a particular dog, select it from the list below.
Choose an animal: Al Pacino Anna Lee Bandit Bastrop Bennie Bibi Birdee Blue Bobby Brigitta Bruno Chickadee Coach Della Street Genny Gigi Ginger Gold Gretl Harry Hermione Honey Bunch Jan Brady Jill E. Bear Lady Pink Liesl Lindsey Margarita Maria Mouse King Nell Nemo Nollie Nyssa Ollie Paul Drake Perry Mason Ruger Sasha Serena Simon Sugar Pie SugarPlum Tracer Tyana Vader Venus Zoey

What will be the primary purpose of this dog?*
Choose one: Companion Livestock Guardian

Please describe in more detail the primary reason you want to adopt a dog:*

How did you hear about us? Please be as specific as you can, for example: "Bluebonnet's Facebook page, a friend's Facebook page, Adopt-A-Pet website, Twitter, Instagram, another adopter, another rescue, a local event", etc.

Have you applied or are you working with another rescue? If yes, please provide the name of the rescue(s).*

Are you committed to providing a caring, responsible home for the dog’s entire life, however long that may be?*

In the event of any major changes in your life such as marriage, childbirth, health problems due to age, going away to college, etc, would that impact your ability and/or willingness to keep the dog?*

List any particular traits are you looking for in a dog.

Who will be responsible for the care of the dog?*

Where will the dog be kept when you are home?*

Where will the dog sleep?*

Where will the dog be kept when you are not home?*

How many hours per day will the dog spend alone?*

Do you have a crate?

Do you own or rent your home?*
Choose one: Rent Own

In what type of home do you live?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

How long have you been at your current address?

Do you plan on moving soon?

Would you ever consider moving somewhere that doesn't allow pets?

If you rent, may we contact your landlord to confirm that you are allowed to have a dog?

Landlord’s name

Landlord’s phone

If renting, is a pet deposit required?

If renting, please enter any size/weight restrictions.

If renting, please enter any breed restrictions.

Number of adults living in the home.*

Have all adults consented to adopting a dog?*

Number of children living in the home.

Ages of children

Are there children who regularly visit your residence?

If so, what are their ages?

Is anyone in your household allergic to dogs?

Do you have a yard?*

If yes, what size is your yard?

Is your yard fenced?*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

Please describe the types of fencing that you have.*

Height of fence

Are any gates securely locked?

Do you have a pool?

If yes, is the pool separately fenced?

Great Pyrenees and some other breeds BARK loudly, especially at night. If you have close neighbors, this can be a nuisance. Will this be a problem for you?*

A home visit and fence check is required. Do you consent?*

If you have livestock, please tell us what kind and approximate number of each species.

If you have livestock, please tell us a little about the layout of your pastures, paddocks, pens, barns, loafing sheds, etc., including which type of livestock is in which location, in proximity to the location where you want a livestock guardian dog to live. This will help us recommend which of our dogs might be best suited to your situation.

Please list your current pets. Please include all types of pets and list their names, age, sex, and breed. If you can include something about their personality and traits, that could be helpful to us in matching the right dog to your household.

Please list any pets that you have owned in the last 5 years that are no longer with you and why (deceased, rehomed, etc). Please include all types of pets and list their names, age, sex, and breed.

Have you had any pets contract parvovirus? If so, please describe where and when this occurred (month and year). What was the eventual outcome? *

If any of your pets are not spayed or neutered, please explain.

Are all of your pets current on appropriate vaccinations and heartworm/flea prevention?

Have you ever given up a pet? If yes, please explain.

Have any current or past pets had behavioral issues?

If yes, please describe.

Have you ever house-trained a dog?*

How would you judge your own experience in training dogs?*
Choose one: None Some Expert

What methods do you use to train/discipline pets?

I/We authorize Bluebonnet Animal Rescue Network or any of their partner rescues to inquire about the health status of my current animals as well as any deceased/no longer owned animals on the records under my/our name. I/We authorize release of shot records, heartworm preventative purchases, and date of each pet's last visit to the veterinary clinic.

Veterinarian's Name

Veterinarian's phone number

Veterinarian's address

NOTE: If you have pets now or have had pets in the last five (5) years, you MUST provide a veterinarian reference, or provide copies of your records confirming that each pet has been sterilized, is current on vaccinations, and is receiving monthly preventives for heartworms, fleas, and ticks.  If you do not have pets now and do not have a preferred veterinarian, please complete the Personal References section. You must provide either a veterinarian reference or personal references. Failure to do so will delay your application. 

List any personal references. Please provide the person's name, phone number, e-mail address, and relationship (please do not include more than one relative).