Bridges to Home

Adoption Application

Applicant Information
Applicant Name *
Address *
City State Zip *
Email *
Home Phone *
Cell Phone
Work Phone
Pet Information
Optional: Select any specific breeds you are interested in.
The purpose of this dog is: *
Applicant Contact
What is the best way to contact you?
What is the best time to contact you?
BTH History
What other rescues have you adopted from?
Are you a previous BTHNM adopter?
If previous BTHNM adopter, what is the previous adopted pet's name and year adopted?
How did you find out about our rescue?
Dog Adoption Request
Are you looking to adopt a dog or puppy?
Age Preference:
Gender Preference:
Size preference (if adopting a puppy : expected when fully grown)
What traits do you prefer in your next dog/puppy?
Are you a first time dog owner?
Are there any community restrictions on the number, size, or breed of dog you are allowed to have?
Are you within those restrictions by adopting the dog you are applying for?
How will your new dog spend its days?
How will your new dog spend its nights?
Regarding the questions above, please explain other:
Do you have a fenced yard?
What type of fence?
What is the height of the fence?
If other type of fence, please specify:
Cat Adoption Request
Are you looking to adopt a cat or kitten?
Age Preference:
Gender Preference:
What traits do you prefer in your next cat/kitten?
Are you a first time cat owner?
Where will your new cat/kitten be staying?
Are there any community restrictions on the number of pets you are allowed to have?
Are you within those restrictions by adopting the pet you are applying for?
Other Pet Adoption Request
Are you interested in adopting an animal other than a cat or dog?
What type of other pet are you interested in adopting?
Gender Preference:
Are you a first time owner to this type of pet?
where will you be keeping your new pet?
Do you have the proper habitat / enclosure to keep this pet?
Are you ready and able to obtain a proper habitat / enclosure?
Do you understand the dietary needs for this specific animal?
Household Pet Information
Do you currently have other pets or animals living in your home?
List of current pets/other animals with AGE and BREED:
How long have you had each of your other pets?
Are all of your other pets Spayed/Neutered?
Are all of your other pets vaccinations up to date?
Have you ever surrendered a pet to a shelter or rescue?
If yes, please explain.
Veterinarian Information
What Veterinary Clinic do you currently use? (Please provide the name and phone number. We will not consider applications without the name and the phone number of the Veterinary Clinic you currently use.)
At your veterinarian, are your animals listed under your name or another name? (Please specify)
Household Information
Do you have children permanently at your home?
Please list all ages of the children in your home:
How many adults live in your home?
What type of home do you live in?
If other type of home, please specify:
Do you own or rent your home?
If you rent your home, do you have written permission from your landlord to have the pet you are applying for?
Please provide landlord's name and phone number (if you rent your home):
If you live in an apartment, do you have a fenced patio?
If you have a fenced patio (apartment), what type of fence?
If fenced patio type is other, please specify:
How tall are the patio walls (if you have a fenced patio)?
Additional Information
Are you willing to take your new pet to training classes if needed?
If it takes some time to find the right match for your family, are you:
What would you do with your animal should you have to move from your present address?
Please provide the name and phone number of at least one personal reference who is not a family member.
What would you do with your animal(s) when you go on a vacation?
Is there anything else you would like to tell us about yourself?
How many hours a day will the dog be left alone in the house?
The Fine Print
  • There is no fee or obligation to adopt associated with this application.
  • Approval notifications are sent on an as-approved basis.
  • The first step of our process is an interview with the applicant, then veterinarian and personal references are contacted. Our volunteers work to process all applications in a timely manner. This processing time is largely dependent on the availability of the applicant and the references provided in this application.
  • We will not hold pets for unapproved applicants.
  • The applicant is responsible for providing accurate information in this application. Providing false information may make you ineligible for adoption.

By signing this form, you agree that you are accepting these terms and you certify that all information contained herein is complete and accurate. You also understand and agree to the points bulleted above.

Adoption Process. There is NO obligation that the applicant must adopt the animal for whom they have applied. There is NO obligation by BTHNM to adopt that or any animal to the applicant. The receipt of an application for a animal is NOT an implied guarantee that the applicant will be selected to adopt that animal. Adoption decisions are a subjective process driven by the foster who best knows the personality and needs of the animal and whose goal is to find the best home for the animal. You may be asked for references (or additional references).


Sterilization. Mandatory with exceptions ONLY made due to the age or health of the pet, and supported by a statement by any of BTHNM approved licensed veterinarians.


Home visit. All adoptions require an application and a home visit by appointment. Vet records may be checked as necessary. References may be requested. An adoption fee ranging from $100 to $300 will be required at the time of completion of the Adoption Agreement. BTHNM will not be held liable for any hazard or damages a new animal may present to known or unknown adults, children, any other animals, or property. Any health issues that may arise as a result of the care provided after adoption will be the financial responsibility of the Adopter.


Certification. All of the information that I/we provided on this application is true and correct. If any of the information changes, I/we will advise BTHNM promptly.


Each party agrees that the signatures provided, whether digital or manual, of the parties included in this Agreement are intended to authenticate this writing and to have the same force and effect as manual signatures.

Signature: ______________________________________________________________________ (digital or manual)

Date: 01/24/2020