Rescue Dog Adoption Application

Adoption Application
Barney's Furry Friends is an all-volunteer, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals. Barney's Furry Friends is completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive complete medical care, which includes worming, vaccinations and spaying/neutering prior to their adoption.
This questionnaire is designed to help Barney's Furry Friends and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Barney's Furry Friends reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!
Applicant Information
Name of the dog you are interested in:*
Your full name:*
Your age:*
Street Address:*
City, State, Zip*
Cell Phone:*

Area CodePhone Number
E-mail:*
What's your profession?*
Employer:*
Character reference and phone number:*
Briefly describe a bit about yourself:*
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:*
How long have you lived at this residence? *
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Height and type of fence
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?*
Have your children been around animals before?

YesNo
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Do you smoke cigarettes?

YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages*
How many of these pets are spayed/neutered?*
Where are these animals now?*
Have you adopted from an animal welfare group before?*

YesNo
If yes, what group?*
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?*
Please provide the name and phone number of your current and/or previous veterinarian or clinic:*
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
Are you aware of crate training?*

YesNo
Have you ever house-broken a dog or puppy before?*

YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
How will you supervise the dog's outdoor activity?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Do you understand that a dog can be an 18 year commitment, and can cost $2000-3000 per year to care for?*

YesNo
Are you planning on purchasing Pet Insurance for your dog?*

Yes, with TrupanionYes, with another companyNo
Do you plan to take an obedience class with your dog?*

YesNoNot sure
If yes, where?*
What circumstances would lead you to give up your new dog?*
If you had to give up your dog, what would you do with him/her?*
How did you find out about Barney's Furry Friends?*

Petfinder.comFacebookOther websiteBosleysInstagram
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Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information