Shelter Adoption Application

Shelter Adoption Application

Revised 6/14/2022
Please review the following points before pre-filling your application:
- Prefilling out this application does not place a hold on an animal or guarantee adoption.
- Your application will be processed only after you visit our shelter to meet and select an animal to adopt.
- Come down to our shelter ASAP to begin the adoption process! Walk-ins only, no appointments necessary. Shelter hours: Monday-Friday 2-6 p.m. and Saturday-Sunday 11 a.m.-4 p.m. We look forward to helping you find your new companion.
- Please note: Animals listed on our adoption pages may still be on stray hold and pending reunion with their owners, or have an existing pending adoption application.
(This form can be filled out in both English and Spanish. To choose your language, please use the button in the upper right corner. Este formulario se puede completar en inglés o en español. Para escoger el lenguaje, favor utilizar el botón de lenguaje colocado arriba en la derecha.)

Shelter Adoption Application

Revised 1/27/2022
Today's Date:*

MonthDayYear
Date
Full name:*
Legal First and Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County of Residence (If not a Maryland resident, skip):
Previous Address (If less than 2 years at current):
Street, City, State and Zip Code
Drivers License/State ID Number:*
BARCS accepts alternate forms of photo IDs. If you do not have a driver's license or state ID, please type "I have another form of ID" in this field!
License State Issued:
Date of Birth:*

MonthDayYear
Format: Month/Day/Year
Email:
example@example.com
Phone Number (Primary)

Area CodePhone Number
Primary Phone Number is a Cell?

Yes
Phone Number (Secondary)

Area CodePhone Number
Please provide an Emergency Contact (friend or family member) to be added to your adopted pet’s microchip registration.
Name:
Phone Number:
Tell us more about your household so we can better assist you (check all that apply):

Children under the age of 10 live in our homeI currently have other animal(s) besides dogs and catsI currently have one or more dog(s)I used to have a dog(s)I currently have one or more cat(s)I used to have a cat(s)I currently have a veterinarian to care for my petsI need a recommendation for a veterinarianOther
I need more information on:

What to do with my pet when they are home aloneHow to introduce my new pet to existing petsHow to start the potty training processOther
I understand that BARCS will share my contact information with our Veterinary Hospital Partner, VCA, for the purposes of benefiting me as a new pet owner, Pet Data for pet licensing renewals, and 24-Hour PetWatch for microchip updates. I understand that I may receive calls, mail, or emails. I understand that I can decline to receive them at any time in the future.*

YESNO
We keep adoption fees at BARCS low in order to save lives. However, on average, BARCS invests $400+ to get an animal ready for adoption. Would you like to make an additional donation to help shelter animals? If YES, please indicate the amount to be added to your receipt:
I have read the questions above. I certify my information is complete and true, and I understand that any false information may void the application. I authorize BARCS to verify the information provided. I also understand BARCS reserves the right to deny my application:*

YES, I confirm and agree
Print Name*
Signature*
Should be Empty: