NAME(s) and BREED(s) OF DOG that interest you: (REQUIRED)

APPLICANT INFORMATION
Your Name:
Phone (Daytime): Phone (Evening):
Your Email Address:
Address:
City: State: Zip:
County of Residence:
Are you over 21? yes ... no
Occupation:
Employer:
Employer Address:
City: State: Zip:
How did you hear about BARK?

HOUSEHOLD INFORMATION
Are you aware of all the rules or regulations in your county or city that apply to pet ownership? (ie ID tags, registration, pet limits per household, etc.) yes ... no
Number of Adults in Household: Number of Children: Ages of Children:
Is this the first dog for you and/or your family? yes ... no
Are all the adults in your household aware that you are adopting a dog/puppy? yes ... no
Who will be the primary caregiver for your new dog/puppy?
Does any member of your household have an allergy to dog hair/dander? yes ... no
What do you hope that a new dog/puppy will add to your lifestyle?
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?
Name of your veterinarian:
Location of your veterinarian (city/town):
Veterinarian’s phone number with area code:
Is there any additional information about your current pets that you would like us to know?
If you have previously had other animal(s), please complete:
1. Name: Breed: Years Owned:
Spay/Neutered? yes ... no
Where is this pet now?:
Name of veterinarian for this pet:
Location of this veterinarian (city/town):
This pet’s veterinarian phone number with area code:
2. Name: Breed: Years Owned:
Spay/Neutered? yes ... no
Where is this pet now?:
Name of veterinarian for this pet:
Location of this veterinarian (city/town):
This pet’s veterinarian phone number with area code:
Others?
Where are the other listed pets now?
Is there any additional information about your previous pets that you would like us to know?

LIFESTYLE INFORMATION
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                 
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
If yes, 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 dog/puppy be left alone?
Where will the dog be kept when alone?
Will the dog/puppy be crated? yes ... no
In what room will the puppy/dog be kept?
Where will the dog be kept during the day when you are home?
Where will the dog sleep at night?
What type of exercise will you give your dog?
How often?
How many hours a day do you realistically have to exercise or play with your dog?
Are there times when the dog will be tied outside? yes ... no
If yes, when?
Do you plan on attending obedience classes with your new dog/puppy? yes ... no
What methods will you use to train your new dog/puppy?
If your new dog/puppy has an accident in the house, how will you correct him/her?

How long do you expect housebreaking to take?
Do you know what causes heartworms in dogs/puppies? yes ... no
Do you agree to keep your dog on heartworm preventative year round? yes ... no
When you go on vacation/travel, who will care for the dog?
If you move, what will you do with the dog?
How much are you willing to spend on medical bills for your dog?
What would you do if the vet bills go over this amount?
Have you ever incurred extraordinary vet expenses? yes ... no
If so, please explain:
Are you ready to take responsibility for this dog for the next 10–15 years? yes ... no
What provisions will you make for the dog should you become unable to care for it?
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 the owner/lister of the dog you are interested in visit where the dog/puppy will be living? yes ... no
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:

Is there anything else you feel we should know?


AUTHORIZATION/RELEASE
By signing (placing your initials on this form) below and submitting this form, I certify that all information given in this application is true and correct, to the best of my/our knowledge.

I understand that BARK is a non-profit organization and is offering the Rehoming Assistance Program as a RESOURCE to help animals in need and is in no way responsible or affiliated with the dog or lister/owner of the dog.

By submitting this form, I hereby further grant consent to BARK and its agents to seek information about me from all named and unnamed sources within this application, including but not limited to veterinarians, rental agents, and personal references, regarding this application. Providing false information or refusing to sign below will result in the rejection of the application or the nullification of any adoption or foster agreement.

Signature/initials of applicant:

Signature/initials of second applicant (if applicable):

The owner/lister of the dog reservesreserves the right to approve or deny any application for any reason and the right not to disclose the reason.