Adoption Application

PROCEDURE: Please be sure to provide as much information as possible on your adoption application to help us determine the best possible dog for you and your family. Our main goal is the successful and permanent placement of each and every dog we rescue into loving forever homes. Once we receive your application, we will review it and contact you to discuss finding a dog that is a great fit for your family. After your references are checked, a home visit will be scheduled with you.

ADOPTION FEES: $400 for puppies, $350 for dogs up to age 6, and $300 for senior dogs age 7+. All dogs adopted thru BarkVille Dog Rescue are spayed/neutered, fully vetted, and microchipped. BarkVille is located in Roswell, GA and our dogs are available for adoption in the Greater Atlanta Area. Applicants in surrounding states could potentially adopt a BarkVille dog if their application is approved, they live within 2-3 hours of the Greater Atlanta Area, and they are able to pick up their dog.

Contact Info

First Name Last Name Street Address City State Zip Cell Phone Home Phone Email

Name of Dog(s) you are applying for Breed/Type Where did you hear about BarkVille Dog Rescue? (if newspaper, which one)?

About You

Other household members to be included on application:

Are you 25 years of age or older?

Yes

How long have you lived at your current address?

Less than 6 months

6 months to 1 year

1 to 3 years

More than 3 years

Name of Employer:

Address of Employer

Work Phone

Are you able to afford the adoption fee?

Yes

Do you plan on moving in the foreseeable future?

Yes

If yes, what are your plans for your pets if you move?

What type of dwelling do you live in?

House

Apartment

Condo/Townhouse

Mobile Home

Do you own your own home/Condo/Townhome?

Yes

If no, please provide the name and contact number of landlord:

Landlord Name: Landlord Contact Number:

Does your landlord or HOA have any breed, weight or fence restrictions?

Yes

If yes, please provide details

How many total hours will your new pet be left alone during the day?

Do you plan to use a crate?

yes

If yes, how many hours will your new pet be in the crate?

If no, where will your dog stay during the day?

Please list the name and age of ALL occupants in household (including yourself):

1. Name: Age:

2. Name: Age:

3. Name: Age:

4. Name: Age:

5. Name: Age:

6. Name: Age:

7. Name: Age:

8. Name: Age:

If no children, do you plan on having children or will children be visiting the household frequently?

Yes

Are any members of your household allergic to animals?

Yes

If yes, please explain:

Who will have chief responsibility for the care of your new pet?

Over the past 5 years, how many pets have you owned, including current pets?

List each individually including breed, age, still living with you? (If not, why?)

Breed: Age: Still with you? If not, why not? Breed: Age: Still with you? If not, why not? Breed: Age: Still with you? If not, why not? Breed: Age: Still with you? If not, why not? Breed: Age: Still with you? If not, why not?

Have you or any other household members (if applicable) ever owned a dog?

Yes

If yes, when? Have you ever lost or given away a pet? (This question does not apply to dogs that died due to natural causes) If yes, please explain If you currently own a dog, how does he/she react to new dogs? Any behavioral issues?

Are you present pets up-to-date on their annual vaccines (including heartworm and flea prevention)?

Yes

If no, please explain

Were your previous pets spayed or neutered?

Yes

If no, please explain What plans do you have for your new pet when you are on vacation or traveling for work? How do you plan on exercising your dog?

Do you plan to do off-leash activities with your dog?

Yes

If yes, please explain Which dog(s) on our website are you interested in? (Applicants interested in dogs we have currently listed will be contacted first):

Age of dog you would consider adopting: (check all that apply)

8 weeks - 2 years

2 - 5 years

Senior

Special Needs

Energy level of dog you would consider adopting: (check all that apply)

Low

Moderate

Active

Size of dog you would consider adopting: (check all that apply)

Under 20 lbs

20-50 lbs

50-100 lbs

over 100 lobs

If considering a puppy, are you prepared to deal with and have you thought about the following issues: Housetraining, chewing, barking, crying at night, high energy level, nipping, socializing, training (we strongly suggest basic puppy classes for all puppies we adopt out)

Yes

Are you prepared to commit to a pet for 10 to 15 years (average life span)?

Yes

Who is your current or most recent veterinarian (if applicable)?

Name: Phone Number:

-----Please call your vet and give permission to release information as many will not give us a reference without your call, and we will not be able to process your application-----

Can and will you provide your dog with monthly heartworm and flea-tick prevention?

Yes

Have you considered and/or budgeted for routine/emergency medical care, licensing, training, supplies, etc. (approximately $1,000 per year)?

Yes

What brand of dog food do you plan on feeding your new pet?

Have you considered the cost of quality dog food?

Yes

How would you deal with any behavioral issues that may arise with your new pet? Are you committed to addressing those issues through training and/or lifestyle changes?

If you listed Other, please explain:

Explain why you might return an adopted dog? (example - aggressions toward other dogs)

At what point would you be willing to take your dog to a professional trainer? (Your vet is NOT a trainer)

Is your entire household in agreement with the decision to bring a new pet into your home?

Yes

If anyone is NOT, please explain:

Are you willing to allow BarkVille Dog Rescue to make future visits to your home?

Yes

Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?

Yes

If so, please explain:

Have you ever adopted or tried to adopt a pet before?

Yes

If yes, please complete this information:

Name of Rescue: Contact Name: Rescueâ€™s Contact Number: Web Address:

Where will your pet spend most of his/her time?

Inside House

Outdoors with somebody

Outdoors unsupervised

Other

If other, please explain:

Do you have a dog door?

Yes

If your dog will spend time outside unsupervised, describe any shelter available:

Are there escape points?

Yes

If you currently do not have a fence, would you be willing to install some type of fence for the security of the dog?

Yes

N/A

Where will your dog eat: Where will your dog sleep:

Would you consider volunteering for our organization?

Yes

Not at this time

If yes, which of the following interest you?

Temporary Foster Care

Interviewing Adoption Candidates

Transporting

Fundraising

Home Visits

Representing us at adoption events

Please provide 3 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved:

Name: Relationship: Email: Phone number: If there is anything else you think we should know, note it here:

Adopter Name (Print Please):

Adopter Signature:

Todayâ€™s Date: Adopter Address: Phone number where you are most easy to reach: Email: