FOR MORE INFO, EMAIL: ADOPT@BARKSOFLOVE.ORG
Please read over our Adoption Terms & Conditions carefully BEFORE submitting an application.
BARKS OF LOVE ADOPTION APPLICATION
COPY AND PASTE AND EMAIL TO: ADOPT@BARKSOFLOVE.ORG
Submitting this questionnaire does not guarantee you will be approved to adopt the animal for which you are applying. Please do not consider this an invasion of your privacy. We here at BARKS OF LOVE ANIMAL RESCUE are doing our best to place all of our animals into permanent, responsible homes, at the same time as find a suitable pet for you. We thank you for your cooperation in taking time to fill out this form.
After submitting this application, please allow 24-72 hours for us to contact you.
All questions are required.
Name: ______________________________
Home phone ( ) ______________________________
E-mail: ______________________________
How do you prefer we contact you? [ ] Home phone [ ] Work/cell phone [ ] Email
Date of birth (mm/dd/yyyy): ______________________________
Employer: ______________________________
Drivers License #: ______________________________
Personal Reference:
Name: ______________________________
Home phone ( ) ______________________________ E-Mail: ______________________________
Which dog are you interested in adopting? ______________________________
Why this particular dog? ______________________________
Please indicate all applicable reasons for wanting to adopt this pet:
[ ] Companion [ ] Watchdog [ ] Family Pet [ ] Gift [ ] Other __________________________
Do you live in a: [ ] House [ ] Apartment [ ] Condo [ ] Mobile Home
Do you: [ ] Own [ ] Rent
How long have you resided at your current address? ______________________________
Does your lease permit pets? [ ] Yes [ ] No [ ] Not sure Are there restrictions? ______________________________
May we contact your landlord? [ ] Yes [ ] No
Name and phone of landlord/leasing office: ______________________________
Would you object to a home visit by one of our representatives? [ ] Yes [ ] No
If you answered "yes", why? ______________________________
Please check all that apply to your home:
____ Busy household - visits by friends, in and out a lot, children, parties at home
____ Noisy - TV, stereo, machinery, tools, children playing, dogs barking
____ Moderate - normal comings and goings
____ Quiet - "homebodies" few guests, come home and stay home
____ Lots of children in the neighborhood
____ Live on busy street
Where will this pet spend most of his/her time?
[ ] Crate [ ] Indoors [ ] Outdoors [ ] Garage [ ] Patio/Porch [ ] Other: ______________________________
Where will your new pet's main sleeping quarters be?
[ ] Crate [ ] Pet Bed [ ] Share bed with owner [ ] Designated Room [ ] Outdoors [ ] Garage [ ] Patio/Porch
What arrangements do you plan to make for exercise and toilet duties? ______________________________
Are all family members aware that you are considering adopting a pet? [ ] Yes [ ] No [ ] Not sure
Do they approve? [ ] Yes [ ] No [ ] Not sure
If there are children in the home, or that visit often, how old are they? ______________________________
How many people, including children, live in your home? ______________________________
Who will be responsible for daily care & feeding? ______________________________
How long will the pet typically be alone in a 24 hour period? ______________________________
How much money do you expect to spend on this pet's care (including any medical care) in a year? _________________
What arrangements do you plan to make for the dog when you travel? ______________________________
Current pets:
Please tell us the breed/size and age of any dogs currently in your home: ______________________________
Are they spayed/neutered? [ ] Yes [ ] No [ ] Not sure
If you answered "no", why no? ______________________________
Are they all up to date on all vaccines, including Bordetella (aka Kennel Cough)? [ ] Yes [ ] No [ ] Not sure
Are they on heartworm prevention? [ ] Yes [ ] No [ ] Not sure If so, what kind? ______________________________
Are they on flea prevention? [ ] Yes [ ] No [ ] Not sure If so, what kind? ______________________________
Are they licensed in your county? [ ] Yes [ ] No [ ] Not sure
What other types of pets, if any, are currently in your home? ______________________________
Have you had other pets in the last five years? [ ] Yes [ ] No
If so, what type and what happened to them (gave away, died of old age, hit by car, etc)? ___________________________
______________________________
If your present living conditions were to change (move, change jobs, divorce, etc), what would you do with this dog? ___
______________________________
Under what circumstances would you feel it necessary to give this dog up?
[ ] Dog barks or whines
[ ] Dog has a potty "accident" in the home
[ ] Dog damages property (i.e. carpeting, furniture, etc)
[ ] Dog becomes aggressive
[ ] Dog becomes very ill
[ ] You move to a different state
[ ] Other (please detail): ______________________________
Have you ever surrendered an animal to a shelter or humane society? [ ] Yes [ ] No
If so, why? ______________________________
May we contact your veterinarian? [ ] Yes [ ] No
Name & Phone: ______________________________
Have you ever been convicted of animal cruelty or neglect? [ ] Yes [ ] No
Any other animal-related violations? [ ] Yes [ ] No
If so, what happened? ______________________________
EXPERIENCE WITH DOGS
The following questions help us assess your experience with dogs so that we can place an appropriate dog in your home. You do not need experience in all of these areas to be approved.
Do you have experience with any of the following? Please check all that apply:
[ ] Crate Training [ ] Obedience Training [ ] Raising a Litter [ ] Modifying Behavior Problems [ ] Potty Training
Please list any other experience that you feel will be beneficial in adopting one of our dogs: ________________________
Are you willing to commit to a training class/program with this dog if required by BOL? [ ] Yes [ ] No [ ] Not sure
Do you understand that we rarely know whether a dog is housebroken or not, and are you willing/able to potty-train this dog if necessary? [ ] Yes [ ] No [ ] Not sure
Check types of confinement you can provide:
[ ] Crate [ ] Fenced yard [ ] Kennel run [ ] Other (please specify): ______________________________
Describe fence or kennel size/type: ______________________________
How do you plan to train/discipline this dog? ______________________________
Do you or any members of your family have any known allergies to dogs? [ ] Yes [ ] No [ ] Not sure
How long are you willing to give this dog to bond with you and settle in to his/her new home?
[ ] One day [ ] One week [ ] One month [ ] Other ______________________________
INTITIAL EACH STATEMENT BELOW:
_____ I understand I am committing to care for this animal and have it as part of my family for its natural life, which can be up to 17 years for a dog.
_____ I am financially able to provide for the animal’s needs. This includes food, supplies, shelter, veterinary care and heartworm prevention, which can be approximately $800 per year.
_____ I have adequate time to spend with my new pet, including time for training, exercise and grooming.
_____ I understand that if I move, my pet will make the move with me.
_____ I understand I must comply with all state and local ordinances concerning pet licensing and vaccinations.
Where did you hear about the pet you are applying to adopt?________________________
All of the above information I have given is true & complete. I agree to follow the Rules and Policies of BARKS OF LOVE ANIMAL RESCUE I understand that it is my decision whether or not to adopt any particular dog. I will not hold BARKS OF LOVE responsible for any damage, injury, or harm caused directly or indirectly to any person or property by any dog I may decide to adopt.
BARKS OF LOVE, AT ITS SOLE DISCRETION, RESERVES THE RIGHT TO REFUSE ANY APPLICANT FOR ANY REASON OR NO REASON.
I have read the disclaimer and agree to these terms and conditions.
Initial Here: ________
SIGNATURE: ______________________________
Approved by:
