MidAtlantic Bulldog Rescue

(Please complete ALL fields)
Applicant Contact Information
Applicant's First Name:
Applicant's Last Name:
Applicant's Age:
Co-Applicant's First Name:
Co-Applicant's Last Name:
Co-Applicant's Age:
Are there children in the household?
Residence Address: (NOT a P.O. Box)
NOTE: Your address must match the address on your photo ID (driver's license or other state-issued identification) and must match the location of our home visit. You will be required to present the identification before you can adopt a bulldog.
City: State: Zip Code:
Email Address:
Home Phone:
Applicant's Cell Phone:
Co-Applicant's Cell Phone:
Years at Residence:
Distance willing to travel to adopt:

Expectations for a Rescued Bulldog
Why do you want to adopt a bulldog?

Are you willing to adopt an older bulldog?
If possibly, please explain?

Are you willing to adopt a special needs bulldog?
If yes, which level of special needs? (Please Note: ALL Bulldogs require some daily care.)

Employment Information - Applicant
Employer Name:
Work Address:
Work Phone:

Employment Information - Co-Applicant
Employer Name:
Work Address:
Work Phone:

All Household Members other than Applicant and Co-Applicant
Age:  Relationship:

Age:  Relationship:

Age:  Relationship:

Age:  Relationship:

Age:  Relationship:

Do Children visit your home?
If yes, ages and frequency:
Are you willing to supervise the Bulldog at all times with children under age 10?
Who will be responsible for caring for the Bulldog?
Is anyone in the household allergic to dogs?
Are all household members in favor of adopting a Bulldog?

Dwelling Information
Type of dwelling?
Do you own or rent?

If rent, Landlord's Name:
Please note: We will contact your landlord to confirm that your lease allows you to keep pets on the premises.
If rent, length of time remaining on lease:

How long do you expect to be at your current residence?

Do you have a fenced yard?
If yes, type?
Height: feet inches
Fully Enclosed?

Describe home in relationship to stairs: Please indicate the number of stairs in each area.
Access to necessary outdoor area:
Access to and from home:
Access to family areas within home:

How will the dog be exercised, how often, and who will supervise the dog while outdoors?

Do you have a swimming pool, pond (including ornamental ponds), in-ground hot tub, lake, river, or any other body of water in or near your residence?
If yes to any of the above, how will the Bulldog be kept out?

Is your home air-conditioned?
If yes, type:
Is your car air-conditioned?
Where will the Bulldog be kept during the day?
Where will the Bulldog sleep at night?
Where will the Bulldog be kept when no one is home?

How many hours will the Bulldog be left alone at any one time, and how frequently?
List all memberships in dog clubs, animal welfare or animal rights groups:

Have you ever been charged with cruelty to animals?
Have you ever been a member of a pure-bred dog association?
If so, which one(s)?

Have you ever owned a Bulldog?
Do you currently own any dogs?
Do you currently own any cats?

Please list all pets (dogs, cats and others) owned now or in the past 3 years. Please comment on the nature of each pet you have. If you have had more than three pets in the past three years, please describe in Comments section.

Name of Pet: Nature of Pet:
Age:  Gender:
Where is it now?

Name of Pet: Nature of Pet:
Age:  Gender:
Where is it now?

Name of Pet: Nature of Pet:
Age:  Gender:
Where is it now?

Additional Pets/Comments:

If any pets listed are no longer with you, why not?

Have you ever given a pet to a rescue organization or animal shelter?
If yes, describe the circumstances.

Do all your current pets get along well with other animals?
If no, explain:

Do all your pets receive regular veterinary care and are they up-to-date on vaccinations?
What heartworm preventative do you use?

Veterinarian Name:
City: State:
Zip Code: Phone:
Note: Please list ALL vets who have treated your pets. You may provide that info in comments. We may ask you to contact your veterinarian and give permission for release of information.
Other Vets/Comments:

If you have adopted a rescue before, provide details:

Pet Care Philosophy
Are you willing to work with the rescued Bulldog to resolve problem behaviors? (e.g., chewing, pulling on lead, barking)
What types of problems would you not be willing to accept?
How will you correct behavior problems?
Are you willing to work with a professional trainer or participate in a training class if recommended?
If no, explain:
Do you understand that rescued Bulldogs may have house-training problems, especially at first?
Do you feel that you are able to meet the expenses of a bulldog, which can be $1000+ per year?
Who will care for the bulldog during your vacations or overnight trips, and where will the bulldog be?
What do you feel is the proper use of crates or cages?

Are you familiar with common Bulldog health problems?
Please elaborate:

Can all household members travel to the rescue group to meet the prospective adoptee?
Do you agree to having a rescue worker inspect your home before and/or after an adoption is completed?
Do you understand that no registration papers will be given to you for the dog?

All Bulldogs adopted from us will be spayed/neutered.
Do you have questions or reservations about this policy?
If yes, explain:

Additional Comments:

I understand that I will be asked to give a donation to MidAtlantic Bulldog Rescue to help with the spaying/neutering and veterinary care of current and/or future rescued Bulldogs. Generally, the donation is $500, although in some circumstances the donation varies.

I have answered all the above questions truthfully to the best of my knowledge. I understand that if, for any reason, I can no longer care for or keep the dog, I must return the dog directly to a MidAtlantic Bulldog Rescue member, pursuant to the terms of the adoption contract, and I will sign all necessary papers for the surrender of the dog.

I hereby make application to MidAtlantic Bulldog Rescue to have my name added to an appropriate waiting list for the purpose of giving a Bulldog a permanent home. I understand that it may be important for me to be available for an interview by phone or in-person on short notice.

I further understand that I will be required to sign a copy of the application before an adoption will be arranged. I agree that if anything on this application substantially changes after I submit the application, including if I acquire a bulldog or any other pet, I will contact MidAtlantic Bulldog Rescue and fully disclose what has changed. I further agree to notify MidAtlantic Bulldog Rescue immediately if I choose to withdraw my application.

We encourage you to review your application carefully before you submit it.

Please review your email address to be sure it is accurate. PLEASE NOTE that we do not routinely make personal contacts in response to new applications, as we receive a large number of applications every day.

However, we will contact you by telephone or email if we need more information from you or you are being considered for a possible adoption. The waiting time to adopt a Bulldog can vary from two weeks to years.

I have reviewed my application carefully and have read, understand, and agree to all above conditions: