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Pre-adoption Application for B.A.R.K

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Pre-adoption Application for B.A.R.K Powered By Docstoc
					Date: ___________________________                                         Dog’s Name: ______________________

                                       B.A.R.K.
                              Bonnie’s Animal Rescue Kingdom

                                        Pre-Adoption Application

Instructions:
   1. Please print neatly and clearly
   2. Provide all required information. Missing information will delay your application.
   3. All references must be contacted before you can adopt.

Please Note:
   •   All members of the household, including pets, must visit with the animal before the adoption is approved
   •   We do not run adoptions on “first come, first served” basis, but try to match the most appropriate home for each
       pet
   •   B.A.R.K. is an all-volunteer, non-profit organization. The adoption fee is a donation to B.A.R.K. to defray
       veterinarian cost of these rescued animals. The fee is NON-REFUNDABLE and to be paid at the time of
       adoption. No exceptions. We reserve the right to refuse any adoption we feel is not in the best interest of the
       animal or adopter.

I. Personal Information:

What type of pet are you seeking to adopt?   ___Dog      ___Puppy (up to 10 mos.) ___Male        ___Female

First Name__________________________________ Last Name ________________________________

Address: ___________________________________ City/State/Zip: _____________________________

Daytime Phone Number: ____________________          Evening Phone Number: ______________________

Email: __________________________________


II. Tell Us About You

How did you hear about B.A.R.K.? ____Web         ____TV      _____Newspaper      _____Friend/Relative

                                    _____Walk/In      ______Internet   ______Other:


What type of house do you live in? ___Single Family     ___Multi-Family     ___Condo/Townhouse        ___Apt.

Do you: ______Own        ______Rent      If rent, landlord name/phone number: _____________________


Make up of household (# of adults, # of children & ages):    _____Adults     _____Children    Ages: ___________

Do any of the persons listed above have allergies? ______Yes      ______No
Please describe the typical word schedule of the person with major pet care responsibility (i.e. word from home, work
M-F, 9-5pm, etc.)




What provisions will be made for your dog if no one is home during the day? ____________________



Do you have a fenced yard? ______Yes          ______No            If yes, height of fence/type: ____________


How often would the dog be unattended in the yard? _________________________________________


What are your reasons for wanted a dog? _____House pet/Companion               _____Gift

                                              _____Guard dog/Watch dog           _____Other (Explain below)




How much are you financially prepared to spend for routine/emergency medical care, licensing, etc.?

__________________________________________________________________________________

Who will have the major pet care responsibility? ____Applicant        ____Mom/Dad          _____Children

                                                     _____Family      ____Other Relative _____Neighbor

Will this be your first dog? ____Yes      _____ No


Do you currently have any other pets? _____Yes _____No

If yes, please specify type, quantity, and ages:

                                     Type (Cat, Dog, other)        Age       Is the animal       How long have
                                                                           spayed/neutered?     you had this pet?
        1.
        2.
        3.
        4.
        5.


Where will the dog be kept when alone? ________________________________________________

Where will the dog sleep at night? ___________________________________________________

Do you plan on crating the dog? _____Yes           _____No _____Maybe
                                                              2
        If so, how many hours a day will the dog be crated? _______# of hours.

What will you do if your dog chews furniture or show other destructive behavior?

____Contact a professional _____Use a book ____Personal knowledge ____Provide Training

___Other, Explain: _____________________________________________________________

Some pets may take 30 days or longer to adjust. Are you willing to give this pet time to adapt to its new environment
and family members? _____Yes ____No

Have you ever lost or given away a pet? ___Yes     ____No If yes, explain: _______________________



Have you ever had a pet killed by a vehicle? ___Yes ____No


Do you intend to keep the dog primarily: ____Indoors ____Basement _____Outdoors _____Garage                ____Confined


Where and how do you plan to exercise the dog? ___________________________________________


Is a change in residence possible within the next few years? ____Yes     ____No


If you were moving to a residence that did not allow dogs, to whom would you give your dog?
____________________________________________________

Who is your current veterinarian? ______________________________________________________
                                    Name & Phone Number (include name of pet and last name records are under)

If you are not currently using a vet, please provide the name and phone # of last veterinarian your pet records are held
with pet names or the name of the vet you plan on utilizing. __________________


III. Our Information

Do you understand there is a non-refundable adoption fee to help cover the expenses of transport, health certificates,
inoculations, and general care for the animals? ____Yes ____No

If requested of you, are you willing to provide written proof that your current pet is spayed/neutered?
 ____Yes _____No

Do you fully understand and agree, under B.A.R.K. contract rultes, the pet you are seeking to adopt will be
spayed/neutered? ____Yes ___No

If you are adopting a puppy that has not been altered are you willing to send a copy of your spay/neuter certificate to
B.A.R.K. once the procedure is completed? ____Yes ____No




                                                            3
Do you fully understand that if you qualify and adopt a pet from B.A.R.K you WILL be contacted for further
verification of the pet’s welfare and will cooperate by providing requested information which MAY include a visit to
your residence by B.A.R.K.? ___Yes ____No

Do you fully understand and agree that if your adopted pet should not work out in your home that, under B.A.R.K.
contract rules, the pet MUST be returned to B.A.R.K.? ___Yes ___No

In the event you qualify and adopt a pet from B.A.R.K. are you willing to provide us with written follow-up reports, if
requested? ___Yes ___No

Do you fully understand that B.A.R.K. reserves the right to refuse any adoption we feel is not in the best interest of the
animal or adopter? ___Yes ____No


IV. References

Please provide three (3) references. These references MUST NOT be related to you nor should they reside with you.
All references MUST BE contacted BEFORE you can qualify for adoption.

      Full Name                Full Address             Home Phone               Work Phone           # of Yrs you have
                                                                                                     known this reference




V. Signatures

Print Name (Individual who completed this form): ____________________________________________

Signature: ___________________________________________ Date: ___________________________

B.A.R.K. volunteer initials & date: __________________________

NOTE:
  All references must be verified before you can adopt
  All members of the household, including pets, must visit with the animal before the adoption is approved.
  We DO NOT perform adoptions on a “first come, first served” basis. We strive to match the most appropriate
   home for each pet.
  B.A.R.K. is an all-volunteer, non-profit organization. The adoption fee is a donation to B.A.R.K. to defray
   veterinarian cost of these rescued animals. The fee is NON-REFUNDABLE and to be paid at the time of
   adoption. No exceptions. We reserve the right to refuse any adoption we feel is not in the best interest of the
   animal or the adopter.

  Volunteers of B.A.R.K. are dedicated to saving abandoned animals. W e ask many
 questions of prospective adopters because we want the puppies/dogs to find a home
that’s just the right match. M any of them have left a less-than-desirable place and we
              want their next home to be theirs for the rest of their lives.


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Description: Pre-Adoption Application for B.A.R.K.