Adoption Application

Why an Application?

Our goal is to match you with a dog that is compatible with your family and lifestyle.  Choices for a long-term animal companion should not be made based solely on looks.  The temperament and energy level of the dog in question must be taken into consideration.

Other Dogs?
If you have another animal companion, you must take the extra effort required to match the personality of your resident dog with the personality of the dog you are wishing to adopt.   This compatible match takes time and research – one size does not fit all; dogs have very individual needs and personalities.

Is there a fee?
There is an adoption fee to adopt one of our rescued dogs. You can learn what’s covered by the adoption fee here.

Type of Dog for You?
Please consider your energy level,  time constraints and space while considering adoption.  If you do not have the time to train a puppy, consider an adult dog.  If you live in an apartment or do not have a fenced yard, consider the time required to provide adequate exercise for your dog.  In snowy, sunny and rainy weather, your dog will still need exercise.  If you have never had a dog, consider fostering before making a commitment to adopt.

Application Instructions:
Please answer all of the questions fully to prevent delays in processing your application.  Please include area codes, zip codes and telephone number(s) of veterinarians.  Please do not skip a question; if the question doesn’t apply to your situation, simply write “N/A.”  Please answer every question on the application. If you do not, the application will not come to us for processing. To make sure your application has gone through, scroll down just past the “Send” button and make sure you see the green box that tells you it was sent successfully. You should hear back from someone within 2 business days. Please email if you have any questions or don’t hear back.

Based on our experiences and the fact that same sex aggression is common in dogs, we prefer not to adopt to homes where a dog of the same sex currently lives.   **Exceptions are made if we are comfortable with the match.**

Thank you for opening your home and heart to a rescued pit bull!

Please answer every question on the application. If you do not, the application will be DECLINED.

    Your First Name (required)

    Your Last Name (required)

    Your Email Address(required)

    Home Address

    City, State, and ZIP Code

    Your Date of Birth

    Your Phone Number (the best one to reach you at)


    Who do you live with?

    AloneFamily- No ChildrenFamily With ChildrenOther

    If you selected "Other," please describe.

    Please list the name and age of every person living in your houme

    Do you have children in your household?


    If yes, please list the ages of all children in your home.

    Do you plan on adding children in the future?


    Do you rent or own your home?


    If you rent, please provide your landlord's name and telephone number

    Do you live in an area where Breed Specific Legislation has been passed?


    What is the name of the dog you are interested in?

    What character and personality traits are you looking for in a dog?

    I love dogs that:?

    I cannot tolerate dogs that?

    Is there a reason you would give up your dog? Moving, Housebreaking, Chewing, Etc?

    Where will you keep your dog?

    Is your yard fenced?


    If your yard is fenced, please describe your fence.

    Is a crate available? If you do not have one now, would you purchase one?

    How will you exercise your dog?

    Do you have other animals?


    Please list CURRENT pets living in your home, including age, sex, breed, how long you have owned them, and gender:.

    Are your other animals spayed or neutered?


    Please list PAST pets you have owned, including age, sex, breed, gender, how long you owned them, and cause of passing.

    Have you ever adopted from a shelter or rescue group before?


    If yes, please provide the rescue group's or shelter's contact information.

    Are you willing to work with a behavior consultant or trainer?


    Please tell us about any experience you may have had with the breed of dog you are interested in adopting.

    Sometimes accidents happen, or severe medical conditions appear. Are you prepared to pay for the costs of these unplanned expenses?


    Do you have a back up plan if an emergency should arise? (Please read the article at before answering this question.)


    Please provide us with the name and number of your current veterinarian. If you do not currently own a pet, please provide the name and number of a veterinarian you have used in the past.

    Vet Name:
    Vet Telephone Number

    What name are your vet records under? Are they in your name, or maybe your spouse's name? Please let us know what name to provide to the vet to help us process your application faster.

    Please provide us with names and phone numbers of at least 3 personal references that we can contact regarding the adoption.

    Is there any additional information you would like to give us regarding your application to adopt?

    How did you hear about Hearts of Gold Pit Rescue?

    Please read this before submitting your application.

    If you skip questions and do not answer them, you will be DECLINED.

    By submitting this application, the applicant agrees to allow Hearts of Gold Pit Rescue to check the references provided.

    The applicant must also agree if they are granted a pet and for whatever reason cannot keep it, they MUST return the pet to Hearts of Gold Pit Rescue.

    Please note that there is an adoption fee for each dog. The fee may vary depending on the dog.