ADOPTION APPLICATION

Please list the NAME(S) of the dog(s) or cat(s) you are interested in? *

Some of our dogs have separation anxiety. Do you work from home? *

Some of our dogs have had poor experiences early in life and can be afraid of women, men or children. Please list who is in your household (age/sex). *

Active military personnel and people with disabilities are offered grants and / or discounts. If this applies to you, please state your status. *

We offer discounts to health care workers and first responders. Does this apply to you and how. *

If you are 65 or over and wish to adopt a pet 5 years or older, we offer a discount as part of our seniors for seniors program. Does this apply to you? *

Some of our dogs are leash trained, some not, and some require more exercise than others. What type of building is your residence? *

A House An Apartment

How long have you lived there? *

Less than 1 month 1-6 months 1-3 years Over 3 years

Will this pet be crated inside the home? If crated, for how many hours? *

If you rent, do you give Brantley Animal Rescue Coalition permission to call your landlord, to verify that you are allowed to have pets in your home? *

Yes No N/A

If permission is given by you to call your landlord to verify that you are allowed to have pets, please enter landlord's name and phone# in box below. *

If pets are allowed, is there a breed/ size limit? *Please note that if adopting a puppy, BARC can not guarantee mature size due to not knowing the lineage of rescue puppies.* *

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

Yes No

Some of our dogs do not get along well with cats or other species of animals. How many pets do you have living in your home? *

0 1 2 3+

What is the name, type of animal, breed, age and gender of your pets? *

Is your dog(s) on heartworm prevention, to prevent heartworm disease and death? *

Yes No N/A

Do you give BARC permission to call your Vet to confirm treatment? If you purchase medical supplies direct, please let us know at the bottom of this application. *

Yes No N/A

Please list the name of your vet. *

First

Last

List phone number and address of your vet. *

Line 1

Line 2

City

State

Zip Code

Country

Does anyone in your home have allergies to animals? *

Yes No

Your pet will take up to 2 months to adjust to his/her new home. Are you willing to allow that much time? *

Yes No

Do you mind if we follow-up to see how your adoption is going? *

Yes No

Your new pet must be brought to your Vet within 2 weeks after adoption to begin heartworm treatment and any consecutive shots which may be needed. A health record will be provided to assist your veterinarian with continuity of care. Do you agree? *

What does a Rescue pet mean to you and why would you like to adopt one? *

Do you understand that if you adopt a pet from BARC and anything happens that requires the pet to be returned, that YOU are totally responsible for returning this pet to BARC? *

I agree to care for the animal I am adopting by providing food, water, shelter, veterinary care and human companionship. I also agree to return the pet to Brantley Animal Rescue Coalition, if for any reason I wish to relinquish custody of the pet. I understand that I may have to wait until a BARC foster home is available before I can return the pet.

PLEASE REVIEW TO ASSURE ALL BLANKS HAVE RESPONSES. ONCE YOU CLICK SUBMIT BELOW, IT WILL TELL YOU IF THE FORM WAS SUBMITTED. IF IT DOES NOT GIVE THIS RESPONSE, ONE OR MORE RESPONSES WERE OVERLOOKED AND YOU WILL HAVE TO PUT A RESPONSE TO PROCEED. THANK YOU FOR APPLYING FOR A RESCUED PET!

​ Adoption Application

Adoption Application