Please Note: All fields with an asterisk * are required, and must be filled out in order to submit your application.

Are you interested in adopting or fostering?
 Adopting Fostering

Primary Adopter's/Foster's Name (First, Middle, Last):*

Primary Appliocant's DOB:*

Full names and ages of ALL additional family members in household:

DOB for ALL family members over the age 18yrs of age:*

Address:*

City:*

State:*

Zip Code:*

Primary Phone Number:*

Secondary Phone Number:

Your Email:*

What is the best time of day to reach you?

What is the length of time you have been at your present address?

If less than one year, please list previous address:

Address:

City:

State:

Zip Code:

If previous address was a rental, list name and number of landlord (if this does not apply to you, please type "N/A"):*

Name:

Phone Number (if this does not apply to you, please type "N/A"):*

Do you rent or own?
 Rent Own

If you rent, please provide name and number of current landlord(if this does not apply to you, please type "N/A"):*

Name (if this does not apply to you, please type "N/A")*:

Phone Number (if this does not apply to you, please type "N/A"):*

Do you have a Home Owner's Association (HOA) (if this does not apply to you, please choose "N/A")?*
 Yes No N/A

If yes, please fill out the HOA's contact information below.*

HOA's Name(if this does not apply to you, please type "N/A"):

HOA's Phone Number (if this does not apply to you, please type "N/A"):

HOA's Email (If Available) (if this does not apply to you, please type "N/A"):*

Have you ever been convicted of a crime?
 Yes No

If yes, please explain.

Name of Employer:

Length of time at employer:

How did you hear about Peace For Pits, Inc.?

When were you hoping to adopt?

What age group would you like to adopt/foster from?

Is there a specific dog(s) you are interested in?

Have you currently filled out applications with other rescues?
 Yes No

If yes, when were applications filled out?

Why are you considering a pitbull?

Please list characteristics that are most important to you when choosing a pet:

Why are you interested in adopting a pet?

How long have you been considering adopting a companion animal?

Is this your first companion animal?
 Yes No

Do you currently have any other companion animals?
 Yes No

If yes, please list all current animals in the household; please include name, age, gender, weight, and breed:

If you have other animals, are they spayed or neutered?
 Yes No

Have you adopted a rescued animal companion before?
 Yes No

How do you plan to introduce your new companion animal to other people/animals in the household?

Have you heard of the “Two Week Shut Down” introduction method?
 Yes No

Are you open to our suggestions on introducing your new pet?
 Yes No

Who is or will be your veterinarian?

Phone Number:

Veterinarian Email (if known):

Address:

City:

State:

Zip Code:

How much money do you anticipate on spending on your new companion animal's annual doctor visits?

What would you do in the event of excessive medical expenses (emergencies and diagnosis of a medical condition)?

What yearly vaccines will your companion animal receive?

Does anyone in your household have pet allergies?
 Yes No

If someone in your household does have pet allergies, how do you cope with that?

If no one in your family currently has pet allergies, but were to develop them in the future, what would you do?

What is the longest period of time you would leave your companion animal unattended outside?

Do you have a completely fenced-in backyard?
 Yes No

If yes, how high and what type?

When you are not home, will the dog have free run of the house, be crated, or be let outside?

If the dog will be let outside, will the dog be in an outdoor dog pen, or will a chain or tie-out be used? If something else is to be used, choose "other," and please detail below.

If "other," please explain:

How will your animal companion get exercise?

Do you have an outside dog run?
 Yes No

Do you have a dog house?
 Yes No

Do you have a training crate?
 Yes No

Do you have a basement?
 Yes No

Do you have a garage?
 Yes No

Do you have a doggie door?
 Yes No

Do you have a balcony?
 Yes No

What are your feelings on dog parks?

Do you and your current pet(s) attend dog parks?
 Yes No

If yes, are they on leash or off leash parks?
 On Leash Off Leash

Where will the animal companion be kept during the day?

Where will your animal companion be kept during the evening?

What brand of food will you feed your animal companion?

What are your beliefs regarding spaying/neutering?

Who will be primarily responsible for feeding/caring for your new animal companion?

What do you believe is the average life expectancy of a dog/cat?

What are your beliefs regarding obedience training?

Have you attended a training program?
 Yes No

If so, where did you attend?

Will you be attending training with your new dog?
 Yes No

Where would you attend training with the new dog?

Have you ever had to rehome an animal?
 Yes No

Have you ever turned an animal into an animal shelter?
 Yes No

Have you ever had to put a pet down?
 Yes No

Why did you have to put a pet down?

What would you do with the dog in the event that you had to move?

How would you handle jumping on furniture/counters/tables?

How would you handle destroying/scratching the furniture?

How would you handle chewing?

How would you handle barking?

How would you handle urinating/defecating where it is not acceptable?

How would you handle being kept up all night?

How would you handle excessive shedding?

How would you handle it if your new animal companion ruined your favorite article of clothing?

How would you handle biting/play biting?

Please provide the names and phone numbers of four references not related to you:

Reference:

Phone Number:

Reference:

Phone Number:

Reference:

Phone Number:

Reference:

Phone Number:

I certify that the information I have provided is accurate and honest.

Signature (First, Middle, Last):

To download a PDF version of this form, please click on the download button. This can be sent in to us via mail or emailed to us here (you must digitize/scan it once you fill it out).

PDF Format: Download           Word Doc Format: Download

Click the button below if you would like to download a copy of the “Two Week Shut Down” Introduction Method.

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Our Address:
Peace for Pits™ • PO Box 5430 • Villa Park, Illinois • 60181