American Bullmastiff Association Inc. Rescue Service - Florida Division

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If you are interested in adopting a Bullmastiff from FLORIDA Bullmastiff Rescue, please print out the following application, complete and sign it, then mail it to the indicated address. Thank you for your interest in one of our WONDERFUL Bullems and we look forward to hearing from you soon! APPLICATION FOR BULLMASTIFF ADOPTION To help ensure the best possible placement of our rescued Bullmastiffs, and in order to determine that the proposed adoption is in the best interest of both the Bullmastiff, and you and your family, please complete each of the following. Please be thorough as possible. Return completed application to: Florida Bullmastiff Rescue Coordinator c/o Mickey Mullen 3899 Kingston Oaks Oviedo FL 32765 Email: crossbow@magicnet.net Phone: 407-365-6760 Florida Bullmastiff Rescue PO Box 4755 Fort Walton Beach FL 32549-4755 Email: BMFResQ@bullmastiffinfo.org Applications will be sent to Mickey Mullen for final review. Name: Full Street Address: City: State: Zip Code: Home Phone: Fax Number: Email Address: Work Phone: Driver s License or I.D. Number: Occupation: Employer: How Long With Employer? Spouse's Name: Spouse s Occupation: Work Phone: 1 of 1

Which Bullmastiff(s) are you specifically interested in? Have you owned other pets before? If no, why do you want a Bullmastiff now? Do you still have the pets listed above? If yes, list kinds and number of pets you have owned in the past: If not, why not, and what happened to the pet(s)? How many pets do you currently own? List species (dog, cat, bird, etc), gender (male, female), age, and how many you own of each. Are all of your pets spayed or neutered? If not, why not? State specifically why you want a Bullmastiff? Have you ever owned this breed before? What specifically have you done to educate yourself about the Bullmastiff breed? Please list your preference regarding: Sex of Bullmastiff: Age of Bullmastiff (list minimum and maximum) Color of Bullmastiff Will you consider something other than your stated preference? List names and ages of all members within your household. Do you (circle one) own or rent your home? If renting - do you have your landlord's permission to keep Bullmastiffs? 2 of 2

Can you provide us with such permission in writing? How long have you lived at your current address? Where will you keep the Bullmastiff: during the day? during the night? during family absences overnight? while on vacation? while on business trips? Do you have a fenced yard? If yes, how large an area is fenced What kind of fencing and how high is it? If you do not have a fenced yard: how will you exercise the Bullmastiff? confine the Bullmastiff? provide for his/her need to eliminate? What is the maximum number of hours your Bullmastiff will be left alone during a 24-hour period? Where will he/she spend this time? Do you object to the discriminate use of a crate? Would you get one? Do you have one? What will you do if your Bullmastiff is destructive when left alone? What kind of vehicle will you use to transport your Bullmastiff? Are you willing to attend obedience classes with your Bullmastiff? Have you ever surrendered a pet of yours to an animal shelter? If yes, why? Have you ever sold or given away one of your pets? If yes, why? 3 of 3

Have you ever trained a Bullmastiff before? If yes, describe the training: Can you afford to spend at least $1000 or more per year for food and routine medical care for your pet? Has anyone in your immediate family/household ever been convicted of a charge related to cruelty to animals or child abuse? Is there any such charge pending? Has any such charge ever been filed? If yes to any of the above, please explain and give disposition of charge. Use additional sheet if necessary. List your regular veterinarian(s)' information: Name of Clinic: Name of Vet: Street Address: City, State and Zip Code Phone Number (include area code) Addition vet information: Please provide the names and phone numbers (include area code) of two nonrelated individuals who can serve as references: Reference #1: Reference #2: Please provide the following information on your nearest living relative: Name: Street Address: City, State and Zip Code Phone Number (include area code) May we visit your home and check your references to verify the information you have provided? What are the requirements for dog ownership in your community? How many pets may you legally have? Are dogs required to be vaccinated against rabies? Is there a leash law? What will you do with your Bullmastiff if you move? Is anyone in your household allergic to dogs? How much time per day will you spend with your Bullmastiff? 4 of 4

What kind of dog food will you feed? Name brand names that you will be using: What hobbies do you have in which you could include your Bullmastiff? What circumstances, in your mind, justify getting rid of a dog? What would you do with the Bullmastiff if the above circumstances occurred? What do you and your home environment have to offer a Bullmastiff that has been neglected/abandoned? How did you find out about us? Thank you for taking your time to complete this application. By signing below you attest to the truthfulness of your answers. Falsification of any of the above information will be grounds to disallow your adoption of a rescued Bullmastiff. Applicant Signature Applicant Signature (If there are two responsible adults in household, both must sign as an applicant.) THIS SECTION FOR USE OF RESCUE GROUP REPRESENTATIVE Application: Approved Disapproved Withdrawn Other Name of Rescue Representative: Phone Number of Rescue Representative: E-mail Address of Rescue Representative: Comments : 5 of 5