Adoption Application If you are not willing to take your role as a pet owner serious, please do not apply.

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1 If you are not willing to take your role as a pet owner serious, please do not apply. I am interested in adopting: Your Full Name Date of Birth (Must be 21 to apply) Name of Spouse/Significant Other Date of Birth Street Address City State Zip Address Primary Phone Business/Alternate Phone Are you aware you are applying to adopt a rescued Pit Bull type dog or mixed breed dog? Yes No Have you owned a Pit Bull type dog in the past? Yes No Do you agree to allow a Sleepy s Dream volunteer visit your home to determine if your home is a safe positive environment for a rescued dog? Yes No Have you EVER been charged with animal cruelty or animal neglect? Yes No In the past 5 years, have you had any pets that were lost, stolen or given away? Yes No If yes, please explain in detail: Under what circumstances would you surrender (give up) a dog? (Examples: new baby, divorce, marriage, new pet, illness, moving, etc) Do you have children or anyone else residing in your home? Yes No List names and ages below:

2 Are your children used to being around pets? Yes No If not, how will you teach your children the correct way to interact and respect your pets? Do all members in your household agree upon this adoption? Yes No Is anyone in your home allergic to dogs? Yes No Do you have any dogs or pets currently residing in your home? Yes No List each animals name, breed, sex and age below: Are your current pets up to date on vaccines? Yes No If not, which ones, and explain why not: Are your current pets spayed and/or neutered? Yes No If not, which ones are not spayed/neutered, explain why: Are your current pets on Heartworm Prevention? Yes No If so, what brand? List your current Veterinarian s name and contact information: Do you agree that whichever dog you adopt through Sleepy s Dream will be kept as indoor family pet? Yes No

3 Do you agree that dogs are family and should be treated with love and respect? Yes No Do you agree to feed each pet daily with fresh water and healthy food? Yes No Do you own or rent? Own Rent If you rent, please list your landlord or property owner's name & contact information below: Do you have any breed or weight restrictions with your landlord, property owner, homeowners insurance or HOA? Yes No Do you have a yard? Yes No If so, is your yard securely fenced in? Yes No If so, please describe fence type and height (i.e. chain link, wood, split rail) If you do not have a fence, what do you plan to do for potty and exercise needs? Where will the dog be kept during the day when you are unable to be at home? (free roam of house/crate/room/fenced area, other) What is the maximum number of hours the dog will be left alone during the day? Your Employer Contact info: How long have you worked at your current job? Are you able to go home for lunch? Yes No Do you have any obedience training knowledge? Yes No What behaviors do you consider unacceptable behavior in a pet and how will you work on these issues? Do you understand that it takes time for a dog to adjust to its new surroundings and that behavioral issue might occur? Yes No

4 Are you willing to allow a day adjustment period for your new dog to adapt to your home, family, routine and any other pets? Yes No Are you dedicated to correcting these issues through positive reinforcement obedience classes, in home training or whatever it may take to fulfill the lifetime promise you have made to this dog? Yes No Many prospective adopters are surprised at the cost of food and medical expenses that are necessary to keep the animal in good health. During the first year you can expect to spend $300 - $500 for routine healthcare. Are you willing to make this financial commitment? Yes No Do you understand the responsibility and commitment you are making this dog by adopting him/her? Yes No Do you agree that it is unacceptable to surrender/dispose of an animal and agree to provide for this animal for the entirety of his/her life? Yes No Please list 2 personal references (no relatives please) who you have known for at least 5 years (include phone number and address). Reference #1 Name Reference #1 Phone Reference #2 Name Reference #2 Phone How were you referred to Sleepy s Dream?

5 **ADOPTING OR PURCHASING A DOG IS A LIFETIME COMMITMENT. PLEASE DO NOT TAKE YOUR ROLE AS A DOG OWNER LIGHTLY. IT TAKES POSITIVE TRAINING, DEDICATION & A CONSISTENT SCHEDULE TO BUILD A LIFE LONG COMPANIONSHIP. IT IS UP TO YOU TO RAISE AN AMBASSADOR AND CARE FOR HIM/HER TILL DEATH DO YOU PART.** If you agree with the terms throughout this entire application and are prepared for this lifetime commitment, please have the person whom will be held liable for this dog print their full name and sign and date below: PRINT FULL NAME SIGNATURE DATE