Primary Email Address:
Secondary Email Address:
SIZE(s) and BREED(s) OF DOG that interest you: (REQUIRED)
Your Name:
Address:
City: State: Zip:
Home Phone: Work Phone: Cell Phone:
Emergency Contact:
Relationship:
Contact Phone Number(s):
Are you under 16? yes ... no
How did you hear about us? (adopted a BARK dog, visited us at an adoption outing, were referred by a friend, saw a business card or flier, found us online, read an article about us in the paper, etc.):
Are you over 21? yes ... no
Occupation:
Employer:
Employer Address:
City: State: Zip:
Number of Adults in Household: Number of Children: Ages of Children:
Is this the first foster dog for you and/or your family? yes ... no
Are all the adults in your household aware that you are fostering a dog/puppy? yes ... no
Who will be the primary caregiver for your foster dog/puppy?
Does any member of your household have an allergy to dog hair/dander? yes ... no
What do you hope that a foster dog/puppy will add to your lifestyle?
Please select the temperament and activity level you are seeking in a dog (select all that apply):
Athletic/High Energy
Quiet
Lap-dog
Mellow
Very Affectionate                 
Have you ever worked with a shy dog before? yes ... no
What type of housing do you live in (detached, town house, apartment, etc.)?
Do you own or rent?
If renting, what is your Landlord’s policy on pets?
If renting, what is your Landlord’s name: Phone number with area code:
Do you have a completely fenced yard? yes ... no
What is the type and height of the fence?
Is there a gate? yes ... no
Do you have a pool? yes ... no
If yes, is there a fence around it? yes ... no
How many hours each day will the foster dog/puppy be left alone?
Where will the foster dog be kept when alone?
Will the foster dog/puppy be crated? yes ... no
In what room will the foster puppy/dog be kept?
Where will the foster dog be kept during the day when you are home?
Where will the foster dog sleep at night?
What type of exercise will you give your foster dog?
How often?
Are there times when the foster dog will be tied outside? yes ... no
If yes, when?
If you presently have other animal(s), please describe:
1. Name: Breed: Age: Gender:
Spay/Neutered? yes ... no
Current on vaccinations? yes ... no
2. Name: Breed: Age: Gender:
Spay/Neutered? yes ... no
Current on vaccinations? yes ... no
Others?
If you have previously had other animal(s), please complete:
1. Name: Breed: Years Owned:
Spay/Neutered? yes ... no
2. Name: Breed: Years Owned:
Spay/Neutered? yes ... no
Others?
Where are they now?:
Name of your veterinarian:
Location of your veterinarian (city/town):
Phone number with area code:
Personal Reference of someone not living in your home
1. Name: Phone number:
2. Name: Phone number:
Have you ever turned a pet into a shelter? yes ... no
If yes, explain:
What methods will you use to train your foster dog/puppy?
If your foster dog/puppy has an accident in the house, how will you correct him/her?

How long do you expect housebreaking to take?
Do you agree to keep your foster dog on heartworm preventative year round? yes ... no
When you go on vacation/travel, who will care for the foster dog?
If you move, what will you do with the foster dog?
Have you previously applied to adopt a dog or cat from a rescue or shelter? yes ... no
If yes, when?
What was the result of your application?
Have you ever relinquished or returned a dog or cat to rescue or shelter? yes ... no
If yes, when and why?
Are you willing to have a BARK representative visit where the foster dog/puppy will be living? yes ... no

Please Review & SIGN
Please read and initial the following information required by VA law for all volunteers of canine rescue organizations. You must sign this before volunteering in any capacity. Please note: Your initials represent your signature.

1.  RELEASE
I, the undersigned volunteer or parent or guardian (if volunteer under 18) understand and agree that a possibility of injury may occur while working with animals. I, the undersigned volunteer (or parent or guardian), desiring to donate my time and talents to Bandit’s Adoption and Rescue of K-9s due hereby release  Bandit’s Adoption and Rescue of K-9s from any loss or injury that may result from my volunteer activities.

2.  POLICIES & PROCEDURES
I, the undersigned volunteer or parent or guardian (if volunteer under 18) agree to review, understand, and support all BARK policies and procedures.  

3.  STATEMENT REQUIRED BY VIRGINIA LAW [Code § 3.1-796.96(2)]
A Virginia law went into effect on July 1, 2003 requiring all “home-based rescues,” which would include BARK (Bandit’s Adoption & Rescue of K-9s) within its definition, to obtain signed statements from anyone adopting from, volunteering with, or connected to us in any capacity that the individual “has never been convicted of animal neglect, abandonment, or cruelty.” 

I, the applicant on this form and undersigned volunteer or parent or guardian (if volunteer under 18), am connected with a home-based rescue as defined under Virginia law, specifically BARK (Bandit’s Adoption & Rescue of K-9s), as a volunteer, fostering individual, and/or adopter. With my signature below, I attest that I have never been convicted of animal neglect, abandonment, or cruelty.

Signature of applicant:
Date:

Signature of Parent/Guardian (if volunteer under 18):
Date: