Name
	Street Address
	City
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	Zip Code
	Daytime Phone Number
	Evening Phone Number
	Best time to contact you?
	Email Address
	What type of housing do you live in?	House Apartment Condo Townhome Trailer Boat
	If living in an apartment, please state which floor
	How long at present address?
	Do you rent or own?	Own Rent
	Landlord Contact Info If you rent please provide landlord's contact information
	Employer(s)
	Household members Please list names and ages of all people who will be living with the dog.
	Occupation of household members?
	Are there any other people who will regularly be in contact with the dog, ie visiting grandchildren, etc?
	Animal Allergies? Does anyone in your household have any known allergies to animals? If yes, please explain.
	Do you have children?	No Yes
	If you have children, are you willing to teach the children the proper way to handle and respect a live animal? Please elaborate.
	Are you willing to accept the additional responsibilities of a Bull Terrier?
	How did you hear about Bull Terrier Rescue?
	Describe your ideal dog
	What other breeds have you considered?
	Why would you like a Bull Terrier?
	Will this be your first Bull Terrier?	Yes No
	Does everyone in the family want a Bull Terrier? What members are enthusiastic? What members are unenthusiastic? Please elaborate.
	Have you and your family discussed whether your lifestyle is such that you HAVE the time and energy to properly care for a Bull Terrier? Please explain.
	Do you have any BREED SPECIFIC laws where you live?	Yes, we have breed laws. No, we do not have breed laws.
	Have you read any other literature on the Bull Terrier breed? If yes, please list.
	What have you learned or found surprising about the Bull Terrier breed?
	Do you fully understand and accept the fact that a Bull Terrier must never be allowed off leash unless within a fully fenced, secure area (ie. NOT a dog park), and then never left unattended? Do you also understand that no amount of training can ever ensure a Bull Terrier can safely be off leash or unconfined, and that not strictly adhering to this restriction will place your Bull Terrier at risk of serious injury or death?	Yes, I understand.
	What would you do if your dog(s) got away and became lost? Please elaborate.
	Do you have a pool or live on a lake?	Pool Lake None
	Does a fence secure the pool area or lakefront?	Yes, it's fenced. No fence. not applicable.
	Have you owned other dogs before? If yes, please list the breed(s).
	List other pets you currently own Please include breed, age, sex and whether they are spayed/neutered.
	Do any of your current pets have characteristics Bull Terrier Rescue should be aware of? Please describe thier temperments. (submissive, dominant, very playful, lethargic, food aggressive, shy, etc.)?
	Have your current dogs been tested for heartworm, and are they on preventative?
	What type of flea protection do you plan to use?
	If you have other animals, are you prepared to spend the appropriate amount of time required to accustom them and the new dog to each other? How will you segregate the dogs when they are not supervised?
	Name / Address / Phone Number of most recent Veterinarian
	Is someone home during the day?	Yes No
	If no, what are your work hours?
	Where will the dog be kept during the day?
	Where will the dog be kept durning the night?
	Who will be the primary caretaker of this dog?
	Do you have a fenced yard? If yes, please list type and height.
	If your yard is NOT completely fenced, how do you plan to contain your dog to your property? Please elaborate.
	Have you checked the yard for dangerous articles, plants, or anything the dog could use to climb the fence?
	Are you aware that Bull Terriers are willful animals, and must be confinded within a fenced are (or on a leash) to prevent them from exercising their powerful instinct to explore?	Yes, I am aware.
	Please describe your exercise plan for your Bull Terrier
	Are you aware that Bull Terriers should be groomed/brushed at least once a week?	Yes No
	Please describe plans for care of your dog while away (ie. vacation, business travel, etc)
	Are you financially able to provide emergency medical care for your dog if the need were to arise?	Yes No
	Are you aware the yearly maintenance of a dog is approximately $200 (not including food or grooming)?
	Are you willing to obtain a crate and crate-train your dog?	Yes, I will get a crate. No, I will not get a crate.
	If you are not willing to get a crate please explain why?
	Are you willing to take your dog to a basic obedience course?	Yes, I will go to obedience class. No, I will not go to obedience class.
	If you are not willing to go to obedience course, please explain why?
	What amount of time and effort do you expect to devote to training your new dog?
	Do you have the time to house train a dog, if neccesary?
	Describe your house-training method
	What would you do if your dog bit someone?
	What would you consider unacceptable canine behavior(s) that would cause you to give your dog up?
	What is your definition of discipling a dog? Please explain in detail.
	Are you willing to have your home visited by appointment by a Bull Terrier Rescue representative?	Yes, I am willing. No, I am not willing.
	Do you understand that dogs must always be MONITORED when interacting with children, with adults, and with other pets, no matter how nice the dog?
	Have you and your family considered that a Bull Terrier generally lives to be 10-14 years old? Are you willing to accept that commitment? Please explain
	Do you understand that no matter how much these dogs are evaluated by their foster families, they usually come with "baggage" we don't know about, and that the transition may take weeks or even months?	Yes, I understand.
	Bull Terrier Preference - what sex of dog would you prefer?	Male Female
	What age of dog would you prefer? Please note rescue Bull Terriers typically range in age from 1 year to 8 years old.
	References Please provide the names, addresses, and phone numbers for two people who are not relatives and do not reside in your household.
	Have you and your family discussed the pros and cons of owning a Bull Terrier? Please elaborate.
	Please use this space to explain why a Bull Terrier will fit in to your family and lifestyle. Feel free to include any further information you feel will help us in evaluation your application.