VETERAN AND FIRST RESPONDERS APP/GRANT

VETERAN AND FIRST RESPONDERS APPLICATION FOR ADOPTION GRANT
(THIS GRANT PAYS FOR 25% TO 100% OF ADOPTION FEE DEPENDING ON STATUS AND NEED)

* Indicates required field

Your Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Alternate Phone Number *

Email *

FORM OF MILITARY AND/OR FIRST RESPONDER SERVICE *

MILITARY FIRST RESPONDER (ER/CRITICAL CARE NURSE, PARAMEDIC, OR EMT

PLEASE EXPLAIN YOUR SERVICE....PANDEMIC, WAR, ANY DISABILITIES RELATED TO THIS SERVICE: *

Do you? *

own rent

Is this? *

a house an apartment

Are pets allowed? *

yes no

Do you have a fenced yard, or an invisible fence? *

yes no

How many hours a day will the foster pet be left alone? *

1-4 hrs 5-8 hrs 8 hrs 8+hrs

Will the pet have adequate shelter from the weather? *

yes no

WHAT DOCUMENTATION DO YOU HAVE OF SERVICE AND /OR RELATED DISABILITY *

How many other pets do you have? *

0 1 2 3+

WILL THIS PET BE USED FOR THERAPY OR SPECIAL NEEDS? *

Have your pets been spayed/neutered? *

yes no n/a

Are they updated on vaccinations? *

yes no n/a

Name of Vet *

First

Last

Phone Number of Vet *

Address of Vet *

Line 1

Line 2

City

State

Zip Code

Country

How many children reside in your home? *

Ages of children? *

How many adults reside in your home? *

Ages of adults? *

Does anyone in your home have allergies to animals? *

yes no

Has anyone in your home been charged with animal cruelty? *

yes no

Agreed to by (Your Name): *

First

Last

Please read the statement below and check the box if you agree. *

Brantley Animal Rescue Coalition Foster Agreement I agree to foster for Brantley Animal Rescue Coalition and to meet all the needs of the fostered pet to maintain a humane condition. This includes FLEA PREVENTION, daily food, water, and shelter from inclement weather. The pet will be kept in a safe environment safe from automobile traffic and other harm. We do not believe that chaining a pet up indefinitely is humane and do not adopt our pets out to those who plan to do so with a BARC pet. I understand that Brantley Animal Rescue Coalition will pay for vaccinations to this pet themselves and will authorize specific and qualified veterinary services to provide spay/neuter services, rabies vaccination, and heart worm test for dogs over 6 months. It is the foster parents responsibility to transport the pet to the vet for all required care such as spaying/neutering, and annual rabies. It is the fosters responsibility to transport the pet to our office for care that does not require a licensed vet such as distemper/ parvo vaccines, bordetella vaccines and worm medication. If the pet requires other services from the vet, I understand I need to first notify Lois Vassilion, at 904-304-8311, before obtaining these services to assure payment. Brantley Animal Rescue Coalition will divulge any known information about the pet agreed on by Brantley Animal Rescue Coalition to be fostered. However, Brantley Animal Rescue Coalition assumes no responsibility for unknown health or behavioral issues or the consequences this might pose. If the pet shows to be aggressive and a potential or real harm to person’s or other pets/animals after being taken into foster care, humane euthanasia will be authorized by Brantley Animal Rescue Coalition by a qualified veterinarian if no safe habitat can be found. The foster parent will abide by the policies of Brantley Animal Rescue Coalition. If the foster parent decides to adopt the pet themselves, they will follow the prescribed procedure as other adopters including adoption fees and entering into an adoption contract for said pet with Brantley Animal Rescue Coalition. If the foster parent breaches the requirements of this contract, the contract will become null and void. The pet will either have to be surrendered to a BARC officer, as soon as an approved foster home is available, or if the pet is not returned, the monies paid for the pet’s care will become due to BARC at that time. If this was a pet that the foster requested our services in placing and the contract is breached or discontinued, the responsibility for the pet(s) will revert back to the person originally asking for placement services. Not complying with a timely follow up with applicants of their fosters and our applications coordinator, is understood to be a breach of contract. In this case, it will be understood that the foster does not intend to adopt out their pet and they assume the liability for the adoption fee.

I agree to not hold BARC, BARC officers or associates liable for any damage or injury incurred in the process of volunteering for BARC *

I agree

Submit

VETERAN AND FIRST RESPONDERS APPLICATION FOR ADOPTION GRANT(THIS GRANT PAYS FOR 25% TO 100% OF ADOPTION FEE DEPENDING ON STATUS AND NEED)

VETERAN AND FIRST RESPONDERS APPLICATION FOR ADOPTION GRANT
(THIS GRANT PAYS FOR 25% TO 100% OF ADOPTION FEE DEPENDING ON STATUS AND NEED)