BCAC Adoption Application

BCAC Adoption Application
Name (or type) of the pet you are applying for:
Today's Date

MonthDayYear
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Primary Phone Number*

Area CodePhone Number
Alternative Phone Number

Area CodePhone Number
E-mail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Number of adults (18+) living in the household:
Number of children (under 18) living in the household:
Age of any children under 18 in the household:
Do you own or rent?
Renters: Does your landlord permit you to have pets?
Renters: Does your landlord have any breed or weight restrictions? If so, what?
Renters: have you paid your pet deposit?

YesNoOther
Landlord's name and phone number:
Please describe your current pets (name, age, type, gender, how long you've had the pet):
Are all of your dogs/cats spayed or neutered?

YesNoNot applicable
If they are not all spayed/neutered, please explain why.
Do your current cats/dogs have a current rabies vaccination?

YesNoNot applicable
If your dogs/cats do not have a current rabies vaccine, please explain why.
Are your dogs kept on heartworm preventatives?

YesNoNot applicable
My current dogs are kept ________ during the day.

InsideOutsideNot applicableOther
My current dogs are kept ________ at night.

InsideOutsideNot applicableOther
When my current dogs are outside, they are:

In a fenced yardIn a pen/kennelTether/runner/chainNo fence. (Dog will be expected to stay in the area on their own.)Electronic FenceOther
My current cats are kept ________ during the day.

InsideOutsideNot applicableOther
My current cats are kept ________ at night.

InsideOutsideNot applicableOther
Please explain where your new pet will be kept during the day?
Please explain where your new pet will be kept during the night?
Have you had any other pets in the past 5 years, if so what happened to them?
Name of primary veterinarian:*
Primary veterinarian's phone number.
May we call your veterinarian as a reference?

YesNo
If you do not have a previous pet with veterinary history, please provide the name and phone number for a professional reference. They may not be a relative.
This new pet will

a pet for me.a gift for someone in my household.a gift for someone outside of my household.Other
I understand that any pet I adopt from BCAC must be sterilizated within 30 days. The appointment time will be discussed and set by a shelter representative. I understand legal action may be filed against me should I fail to comply with this state law.

YesNo
Please leave additional comments/concerns here
If you are under 21 years of age, please provide a parent or legal guardian's phone number.
We generally reply to adoption applications by email. Is this ok?

YesNo, I prefer to be contacted by phone.
Are we able to text you on the primary number you provided to obtain additional information or clarification regarding your application?

YesNo
By signing my electronic signiture here, I agree that all of the information I proved is true to the best of my knowledge.*
***Please note that failure to comply with the spay/neuter requirement can result in an arrest warrant and/or repossession of the animal.***
Should be Empty:

BCAC Adoption Application

***Please note that failure to comply with the spay/neuter requirement can result in an arrest warrant and/or repossession of the animal.***

Please note that failure to comply with the spay/neuter requirement can result in an arrest warrant and/or repossession of the animal.