National Brittany Rescue & Adoption Network (NBRAN)

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Adoption Application

Volunteers of National Brittany Rescue & Adoption Network are dedicated to this breed. We ask many questions of prospective adopters because we want the rescued dogs to find a home that's just the right match. Many of them have left a less-than-desirable place and we want their next home to be theirs for the rest of their lives. Please be sure to educate yourself before choosing a dog of any breed. 
Before you decide on adopting a Brittany please read Choosing A Brittany, Click Here

Our Brittanys have been rescued or surrendered and have been through stress of change and loss of owners.  We are looking only for owners that are committed to being “forever” homes.  This means being part of your family in all aspects.   Additionally, all “forever” homes must commit to the following medical care provisions:

  1. Annual vet visits
  2. Heartworm Prevention
  3. Vaccinations as prescribed by your local vet
  4. Register/Maintain Microchip information (if pet is microchipped)

If you would like to adopt a Brittany through the National Brittany Rescue & Adoption Network, we would love to help you do that. Please fill out this form and submit it. Once your application is reviewed, we will be happy to discuss adoptions further with you. Thank you in advance for your interest in helping these Brittanys. 

NOTE: If you experience problems submitting this form, please contact the webmaster with information about what happened when you tried to submit it.

First Name *
Last Name *
Address
City *
State/Province/Country *
Zip/Postal Code
Primary Contact Phone # (Area Code/Number) - -
Cell Phone
Emergency Contact (name & phone #)
E-Mail
What type of area do you live in?
How did you hear about us?
(limit of 200 characters including spaces)
If you have an application pending with any other rescue group, please list their name here.

Have you ever had a Brittany (or other dog)?  If yes, what happened to it?
(limit of  200 characters including spaces)

Please list any other pets you have in the home:  
Pet Name Pet Type Neutered/
Spayed		 Current
Shots		 HW
Prev.		 Gender Age Status
Are you looking for: (check all that apply) family pet younger dog
hunting companion older dog
male outdoor dog
female indoor dog
What traits are you looking for in a dog?
(limit of  200 characters including spaces)
Have you ever rescued a dog before?

Do you have children? Ages? 
(limit of  200 characters including spaces)

If you plan on having children in the future, how will that decision impact your rescue dog?
(limit of 200 characters including spaces)
Do you rent or own your home?  
If rent, can we contact your landlord to verify that pets are okay?  
If yes, please enter the name and phone number of your landlord.
Do you have a fenced yard?
 
If yes, what type of fence?
 
How high is the fence? 
Have you checked for escape routes?  
How large (in area) is your yard?
Do you have an outside kennel?  
How much time will the dog spend alone? Where will he/she be? 
(limit of  500 characters including spaces)
Where will the dog sleep?
(limit of  200 characters including spaces)
What activities would you like to do with your dog? 
(limit of  500 characters including spaces)
Are you interested in obedience-training your dog?  
Do you intend to crate-train your dog?  
Would you be willing to allow us to visit you and your new dog after the adoption?  
If you answered " No", please give a reason:
If, for some reason, you are not able to adopt one of these animals, would you be interested in dogs that may become available in the future?  
Please understand that most rescue dogs are older, and make wonderful pets.
Are you willing to give the dog at least 6 months to adjust to you, your family, and the new environment? *  
For what prime reasons would you give up, or get rid of a dog? 
(limit of  500 characters including spaces)
Have you ever been convicted of animal cruelty, abuse, and/or abandonment pursuant to any past and/or present laws of the State(s) or municipality(ies) where you have lived in the past or currently reside?  
May we contact your veterinarian for a reference? 
  
If no, please explain.
(limit of  200 characters including spaces)
If yes, please include your vet's name and phone number and name of prior dog or pet seen by this vet.   (limit of  500 characters including spaces)
Are you interested in any particular Brittany currently featured on our website? Please enter the dog's name and the Brittany Rescue person listed for that dog. (Click here to open a window to view dogs again) (limit of  500 characters including spaces)
Do you have any questions or concerns about adopting a rescued dog that we might be able to answer?  (limit of  1000 characters including spaces)
 
  © NBRAN 2011