Contact Information
Primary Email Address:
Secondary Email Address:
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

Availability
Please list the days of the week that you are available:
Please list the time of day that you are available:
Please indicate how often you would be able to report to the BARK farm (weekly, twice a month, once a month, etc.):

Education
Current occupation:
Other hobbies, skills, interests:
Previous volunteer experience:

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 part of a volunteer organization or are you volunteering on your own?

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: