Adoption Application

Mandatory field*

First Name :*

This is a mandatory field.

Spouse/Partner Name :
Address :*

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City :*

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Zip :*

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Work Phone :
Cell Phone :

Fax :
Email :*

Please enter a valid emailaddress like user@example.com.

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Alternate Email :

Please enter a valid emailaddress like user@example.com.

Which dog are you applying for (give the name and state) :

Have you been in touch with the person listed as the contact :

If you are interested in more than just one dog, please list them here :

Would you prefer a male or female :

What age range are you looking for in a dog :

What is the best time and method to reach you (phone, email, day, evening) :

How many adults - age 18 and over - live in this home? Do they all agree they want to adopt a dog :*

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How many children (if any) are in the home? What are their ages :*

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Have you ever adopted from ABR before? If so, when :

How did you hear about us :

If you ever adopted from another rescue group and couldn't keep it, did you return it to the group? Please explain further :

List your current LIVING pets. Please include their breed age, gender, if they are spayed or neutered and if they are kept indoor or outdoors. Please do not omit any of this information :*

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If your current pets are not spayed/neutered, please explain why :*

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

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Have you ever taken an animal to a pound or shelter? If so, please explain :

What traits are you looking for in a Brittany? Companion, hunter, service dog, agility, couch potato, good citizen, etc :

Expected activity level :

In what type of home do you live :*
single family duplex apartment townhouse condominium mobile home military housing

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If you rent, have you received the approval of your landlord to have an animal :*

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If you rent, please enter your landlord's name and phone number :*

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Is your yard fenced :*
No Yes

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What type of fence :*
none privacy fence chain link fence invisible other

This is a mandatory field.

What is the height of the fence :

Have you ever used a crate with a dog before? Please explain :

Will your Brittany be living indoors with the family :*

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How much time will the animal spend alone at home :*

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Where will the animal sleep :*

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Where will the animal be kept when you are home :*

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Where will the animal be kept when you are not home :*

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Describe how you will train the pet :*

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Have you ever taken a dog to an obedience class before :

What circumstances do you feel justify giving a dog up? :*  (select all that apply [select/de-select cntl-left-click])
Moving New baby Divorce Doesn't get along with other pets Gets out of fence Chlidren lost interest Behavioral problems It gets too big Too time consuming Shedding Allergies Housebreaking issues Aggressive behavior Animal's medical issues Death Other None

Please explain further what circumstances would cause you to give up your dog :

If you have or had any pets, please list the veterinarian's name and phone number :

List at least two references, please include full contact info :*

This is a mandatory field.

Why are you interested in adopting a Brittany at this time :

Have you applied with any other rescues? If so, which ones :

If you have any further questions or comments, please include them here :