“APPLICATION TO ADOPT”
from Bark Park Rescue
We sincerely hope we have an animal that fits your needs. Please fill out this questionnaire completely. It is designed to help us find you the most compatible pet with your lifestyle. Our ultimate goal is to match the right dog with the right home for the enduring happiness of both dog and adopter. This isonly an “application” and does not guarantee you will be adopting one of our dogs.
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
PLEASE ANSWER ALL QUESTIONS FOR EACH ADULT LIVING IN THE HOME.
Name of Dog(s) You Wish to Adopt: ______Where did you see him/her?______
Adopter’s Name(s):______Email Address: ______
Primary Phone: ______Type : Home Cell Office
Alternate Phone:______Type : Home Cell Office Fax: ______
Address: ______City: ______State:_____ Zip Code: ______
Address where pet will reside: ______
Occupation: ______Employer Name: ______
How long there?______yrs. ______mos. Work Phone: ______
Address/City/State/Zip: ______
DRIVER’S LICENSE #: ______STATE (REQUIRED) ______
Why are you interested in this pet? ______
Please list the pets you now have in your home:
Type/Breed Name Sex Spay/Neut? Age Owned Since Comments
______
______
Do you use Heartworm Prevention? Y / N What brand: ______Where do you purchase it?______
Are your current pets up to date on shots? Y / N Dog food brand/type: ______
PLEASE LIST PREVIOUSLY OWNED PETS
Type/BreedName Sex Spay/Neut? Age Dates OwnedWhat happened to him/her?
______
______
Have you ever surrendered a pet to a shelter or given one away? Y / N
What were the circumstances?
OWN OR RENT? House __ Condo __ Apartment __ Townhouse ___ Live w/ parents ___
Other___ (please explain) ______
Name of Complex/Community: ______Landlord’s Name: ______
Address/City/St/Zip: ______Telephone: ______
Do you have a securely fenced yard? Y / N How High? ______
If not, are you willing to leash walk at all times? Y / N
How many Adults are in your household? ______How many Children? ____ Ages:______
Do you have much contact with grandchildren or neighborhood/other children?Yes____ No____
What are the working hours of the adults in the house? ______
This dog will be alone without human companionship for about ____ hours per day. How many days? ______
Where will this dog be kept during the day?______At night?______
Where will this dog be kept when left alone? ______
Where will this dog sleep? ______
Who will be primarily responsible for the careof thisdog? ______
Some dogs require a special diet – Is that OK with you? Y / N
Does anyone in the home have any allergies to dogs or other pets? Y / N
Are you willing to take the time to work with a dog on housebreaking issues? Y / N
Knowing that some rescue pets have had little or no training, are you willing to take the dog to obedience classes and/or hire a trainer to help with any behavior problems that may arise? Y / N
Have you personally ever taken a dog training class or worked with a dog trainer? Y / N Where/When?:______
What training methods have you usedin the past?______
Do you understand and agree with crate training? Y / N Have you ever used it? Y / N
Your Veterinarian/Veterinary Clinic is (or was): ______
Address: ______
City/St/Zip: ______Telephone: ______
Would you object to our visiting your home and meeting all members of your family? Y / N
Under what circumstances would you NOT keep your new pet(s)?
Move to a new place that would not allow pets?Y / N Move out of state?Y / N Too much hair?Y / N
Digging?Y / N Pet grew too large?Y / N Chewing?Y / N Barking?Y / N Housebreaking Problems?Y / N
Kids ignore pet?Y / N New Baby?Y / N Allergy?Y / N Pets didn’t get along?Y / N
Destructive behavior?Y / N Family changes/new relationship?Y / N Expensive vets bills? Y / N
Other (please explain)______
PLEASE NOTE!! When adopting a puppy, if the puppy is returned after 4 months, there will be a “rehoming fee” of $250.00. Puppies are a very big responsibility and should be seriously considered, before adopting. There are NO bad puppies, only lack of knowledge and training by the owner. All puppies grow up to be dogs, and they still need the love and companionship of a family. I AGREE_____ I DISAGREE ______
I have read the above information carefully have filled out this application honestly. I understand the omission of information and/or failure to answer all questions sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand accept that you have the right to annul the adoption reclaim the dog. I give you permission to fully investigate the information provided as well as contact veterinarians related officials. Furthermore, I understand accept that the adoption decision depends upon many factors, including -- but not limited to--the compatibility of the family home to this individual dog, as well as other applications received on this dog. I understand accept that it is your prerogative to decide which home is most appropriate for this animal, I will not take issue with your decision. Unless otherwise indicated by you, I may be considered for another dog if I am not chosen for this one.
Signature ______Date______
Printed Name ______
Additional information or comments you would like us to know about?:______
______