Pit Crew Illinois
Training & Rehab
One pit bull at a time.
Have you ever been convicted of a felony?
Interested In (dog’s name):
Social Security Number:
Drivers License Number:
Street Address 1:
Address Line 2:
Type of housing:
Can you provide a copy of lease (if applicable):
Landlord’s phone number:
Years at current address:
If under 2 years, previous address:
Home phone number:
Cell phone number:
How many adults in the house:
Name, age and relationship of other adults:
How many children in the house:
Age of children:
Do you have a fenced yard or kennel run?
If so describe:
Does anyone in the home have allergies:
Do all the adults in the house want a pit bull?
If not, who and why:
Are there other dogs in the house?
If so please provide breed, sex, age and if they are spayed/neutered:
Any cats in the house:
How many other animals have you had in the past 5 years:
Where are they now? Still alive, put to sleep, given away, lost, hit by a car:
Employer phone number:
Years at employer:
Typical hours worked:
How will you handle exercise and potty needs:
How many hours will the dog be left alone:
Who will be the primary caregiver of the dog:
Why do you want a pit bull:
Describe your lifestyle:
Where will the dog live primarily:
What activities will your dog participate in:
Will you crate your dog when needed?
If no, why:
How will you handle mischievous behavior, digging, chewing, etc:
How will you handle any unwanted behavior:
What would cause you to return the dog:
Are you prepared for the personal attention this breed needs:
Do you have the time and ability to train and exercise a strong, large dog
Are you ready to commit the next 10-16 years to this dog:
Current vet’s name:
Current vet’s address:
Current vet’s phone number:
Please provide 2 personal references (not relatives)
Please provide 2 family members who will know your whereabouts for the next 5 years:
THE INFORMATION ON THIS APPLICATION WILL BE KEPT CONFIDENTIAL.
BY SUBMITTING THIS APPLICATION, I CERTIFY THAT ALL INFORMATION PROVIDED IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT YOU MAY RUN A BACKGROUND CHECK AND WILL CHECK ALL MY REFERENCES.
AGREE and DIGITALLY SIGN.