Please fill out the form below or download a PDF and bring with you to one of our many adoption events: Adoption ApplicationDateDogs You are interested in:[1][2][3][4]Personal InformationName(s):Name [1](required)First M. LastName [2]First M. LastName [1] Birthdate(required)Name [2] BirthdateAddress:Street(required)Apt #City(required)State(required)Zip(required)Contact Information:Home(required)Work(required)CellEmail address(required)Employment Information:Your Occupation(required)Spouse OccupationYour Place of Employment(required)Name, Location and Contact NumberSpouse Place of EmploymentHousehold InformationPlease list children/minors in the home (name/age)[1][2][3][4][5]AgeAgeAgeAgeAgeDo children/minors have experience with dogs?(required)YesNoWhat level of supervision will children/minors have with the dog?List other family members/roommates/boarders that reside in household? (List name, age and relation)[1][3][5][2][4][6]Has everyone in your household been included and agree with the decision to adopt a pit bull type dog?(required)YesNoWho will be the primary caretaker for the dog?If no, please explain...(required)Other Pets in the HouseholdDo you own other pets?YesNoPlease list them below:Pet #1NameBreedSexMaleFemaleTemperment SpeciesAgeSpayed/NeuteredYesNoPet #2NameBreedSexMaleFemaleTempermentSpeciesAgeSpayed/NeuteredYesNoPet #3NameBreedSexMaleFemaleTempermentSpeciesAgeSpayed/NeuteredYesNoAre all pets up to date on vaccinations?YesNoAre all pets on heartworm prevention?YesNoWhat type?Please tell us about any other pets you have owned in the past 10 years:[1]NameBreedSpayed/NeuteredYesNoSpeciesAgeIf applicable, please explain why you no longer have this pet:[2]NameBreedSpayed/NeuteredYesNoSpeciesAgeIf applicable, please explain why you no longer have this pet:[3]NameBreedSpayed/NeuteredYesNoSpeciesAgeIf applicable, please explain why you no longer have this pet:Residence InformationResidence Type(required)HouseAttached Home/Duplex/FlatApartmentMobileOtherWhat Type of Environment is Your Home Located?(required)City/UrbanSuburbanRuralOtherDo You Rent or Own?(required)RentOwnFor Renters:Does your landlord accept dogs?(required)YesNoAre there any breed restrictions?(required)YesNoLandlord's name / phone number:(required)Do you have renter’s insurance?(required)YesNoFor Home Owners:Homeowner’s insurance company name:Name and phone number of homeowner’s insurance agent:Does your home have a yard?YesNoIs it fenced?YesNoHeight of fence?Is the fence secured with a lock?YesNoN/AIs it fenced separate from the yard?YesNoN/AFence TypeWood/VinylConcrete/Brick /Structural WallChain-LinkWrought IronElectricOtherDo you have a pool?YesNoPlans for Your New DogPlease tell us what purpose the dog will serve in your life (check all that apply)(required)Companion for youWorking dogCompanion for pet Companion for childCompanion for entire family Guard dog for business Guard dog for personal/homeOtherPlease Explain:Where will the dog spend most of its time?What outdoors areas will the dog have access to?How many hours will the dog be left alone per day?Where will the dog spend most of its time when alone?How do you feel about crating the dog?Where will the dog sleep at night?If you have other pets, how will they be managed when unsupervised?How do you plan to exercise the dog?Please describe your expectations regarding the dog’s behavior/trainingAre you willing to enroll the dog in a training class upon adoption?(required)YesNoIf behavior problems arise in the future, are you willing to hire a trainer or behaviorist?(required)YesNoVeterinarian’s Name (required)Type N/A if no current vetPractice NamePhone NumberIf no current vet, are you willing to research prior to adoption?YesNoAre you familiar with emergency clinics around you area?(required)YesNoAre you willing to research prior to adoption?(required)YesNoOwning a pet is an investment in both time and money. Can you afford proper vet care, training, shelter, food, boarding, etc?(required)YesNoHow much do you expect to spend each year for basic care?(required)Enter your best guesstimate.How much do you expect to spend in an emergency?(required)Enter your best guesstimate. Under what circumstances would you decide not to keep your new dog?(required)MovingNew roommateBehavioral problemsSeparation/divorceIllness/allergiesVeterinary expensesPregnancy or new babyNew carpet/furnitureChange in employmentOtherNone(check all that apply)Please ExplainWould you object to an inspection of your premises prior to adoption?(required)YesNoPlease provide 3 references not related to you that we can contact to attest your character.Name(required)Name(required)Name(required)Phone(required)Phone(required)Phone(required)Relationship to you(required)Relationship to you(required)Relationship to you(required)Please provide any additional information that you would like us to know about you as a potential adopter:How did you hear of Even Chance: Pit Bull Advocacy + Resources + Rescue?We will attempt to provide you with an honest evaluation of temperament on any dog we have to place. Do you realize that often times the complete history of a dog may not be known and you may encounter some behavioral problems?(required)YesNoIf applicable, are you willing to help work with us to correct these issues?(required)YesNoAre you willing to submit to a home check, follow up visit and continued contact with us if necessary in the future?(required)YesNoAdditional comments or concerns?Under what circumstances would you decide not to keep your new dog?*This application does not guarantee adoption. Adoptions are decided by all members of even chance and do not happen on a first-come, first-serve basis. Much consideration is taken for all applications for each and every dog! You will be contacted regarding your application as soon as possible.Signature [1](required)Signature [2] Please only press submit once. The form could take up to 2 minutes to compile and send. Thanks for your patience .Submit ApplicationThis field should be left blank