Bud's Place, Inc. (BPI)
Rescue Dog Adoption Or Volunteer Application

Please note: There is a non-refundable adoption fee for all rescues. This is used solely for the medical care and treatment of all of the rescue dogs. The adoption fee is usually stated under the pet's description on Petfinder.com. We offer a rescue discount to senior citizens!
We are all volunteers, and most of us hold full-time jobs. We are not paid for our rescue work, so please be patient while your application is being processed. We request that you check on the status of your application by email only.
Bud's Place, Inc. reserves the right to refuse or disapprove any application based on national guidelines. Priority may be given to local adopters, or those adopters who pick up the rescue in person, to alleviate as much trauma to the rescue as possible.
Incomplete applications may cause a delay in processing. Please be sure to provide full names and telephone numbers where requested, and delete/erase all question marks from your answers.

Your First and Last Name:
Full Street Address, City, State, and Zip Code:
Occupation:
Home Phone:
Work Phone:
Cell Phone:
Your Email Address:
Spouse, Partner, or Room-mate's (SPR) First and Last Name:
    SPR's Occupation:
    SPR's Work Phone:
    SPR's Cell Phone:
    SPR's Email Address(es):
Best Time and Phone Number to Call:
Are You Applying to Adopt a Pet, Temporarily Foster a Pet, or Volunteer in Another Way:
For All Animals You Have Owned In The Last Ten Years, Please List Your Veterinarian's Name, Clinic Name, City, and Phone No. so We May Verify Your Pets Care.
By submitting this application you authorize your veterinarian to release any and all medical records on any of your pets (past and present) to BPI for purposes of this application:
Your First Personal Reference (Not a Relative), Address, Home Phone No., and Best Time to Call:
Your 2nd Personal Reference, Address, Home Phone No., and Best Time to Call:
Your 3rd Personal Reference, Address, Home Phone No., and Best Time to Call:
Please List All People Living in Your Home, Their Relationship to You, & Their Ages:
How Long Have You Lived At Your Current Address:
Do You Own or Rent Your Home: Own Rent
Other (Explain Below):
If You Rent, Does Your Rental Agreement Permit Pets? How Many? Please List Any Size or Breed Restrictions:
If You Rent, Please Provide Landlord Name and Phone Number:
If You Have a Yard, is it Fenced? If So, What Type, Material, and Height? Are All Exterior Gates Padlocked? If Not Fenced, How Would You Keep Your Pet in Your Yard. Do You Have a Doggy Door:
Would You Crate Your Pet? If So, Please Describe Crate and How Long Pet Would Be Crated:
Please Describe In Detail Where the Pet Would Spend Its Time During the Day:
        And At Night:
        And When You Are Not Home. How Long Would It Be Home Alone:
Exercise and Elimination For the Pet Will Be (Check All That Apply): on Lead or Leash   Tie-out or Trolley
Fully Fenced Yard   Partly Fenced Area
Electronic Invisible Fence   Loose in Yard  
Indoor Potty Papers/Box
Do You Have a Pool, Spa, Hot-Tub, or Fountain? Is It Above-Ground or In-Ground? Is It Separately Fenced:
If It Is NOT Separately Fenced, How Will Your Pet Be Protected From This Area:
Please List Any Pets You Have Owned For The Last Ten Years: Cat/dog, Name, Breed, Age, Spayed/Neutered, and current location.
    Where Are These Pets Now?
    If Any Are Deceased, Please Give Name, Age At Death, and Cause of Death:
Please Explain If You Have Ever Re-homed or Given Up a Pet:
Please List All Animals That You Presently Own, (Including Exotics Such as Birds or Reptiles), Their Breed, Age, Gender, Medical Conditions, and Attitude:
On Heartworm Preventative?
Please List Brand of Heartworm Preventative and How Often Given: 		Yes No
Are You Interested In A Particular Pet? If So, Please List Pet's Name and Breed or Description, as Well as a 2nd Choice:
If You Have A Preference For Male or Female, Please Explain Why:
If Your Application is Approved, Do You Agree to Return This Dog to BPI, or its Affiliate, if You Are Unable To Keep It For Any Reason: Yes, I Agree.   No, I Do Not Agree
If You Are an Out-of-State Applicant, Please State How You Intend to Transport The Rescue.
Please note that, based on availability, we have rescue volunteers who can many times transport the rescue to his/her new home. The charge for this service is $200 and is paid directly to the volunteer, who will take the rescue onboard for their flight home.
IMPORTANT!
As a potential adopter, I do hereby certify that all of the information contained in this application is true and complete. I understand that if any of the information is inaccurate or incomplete, my application will not be processed. I further understand and agree that if chosen as an adoptive home, I will comply with the following conditions of adoption.
1. Adopter shall keep Adoptee as an INDOOR pet, and will provide Adoptee with identification at all times (collar tag, tattoo, or microchip). Adoptee will be kept under control at all times when off Adopter's property.
2. Adopter shall provide adequate veterinary care for Adoptee, including annual vaccinations, rabies vaccination as needed, and any other care recommended by Adoptee's veterinarian. Adopter will take adoptee to veterinarian if ill. If Adopter is unable to do so, Adopter will notify Bud's Place contact.
3. Adopter agrees to notify Bud's Place contact of any change of address or telephone of Adopter.
4. If Adoptee is lost or stolen, Adopter will immediately notify Bud's Place contact.
5. Adopter shall return Adoptee to Bud's Place if under any circumstances Adopter is no longer able to keep or provide for Adoptee. Adopter shall not sell, give, or otherwise transfer Adoptee to anyone other than Bud's Place.
6. ADOPTER REPRESENTS THAT NO MEMBER OF HOUSEHOLD HAS EVER BEEN CHARGED WITH CRUELTY TO ANIMALS.
7. Adopter shall indemnify and hold harmless Bud's Place and its members from any and all loss, damage, or expense. Bud's Place does not warrant the temperament or behavior of Adoptee. Bud's Place does not warrant the health of Adoptee, but does provide all medical records available. Bud's Place is not liable for acts of Adoptee after placement with Adopter.

Please click SUBMIT now. It will email your application to us, then return you to our homepage. Please email us at buddog@houston.rr.com if you haven't heard from us within one week. Please check your SPAM folder first!

(After Receiving Our Approval to Adopt) Your Signature and Date:

Spouse, Partner, or Room-mate's Signature and Date: