Rocky & The Bark Bunch Rescue Pet Adoption Application Form

Rocky & The Bark Bunch Rescue Pet Adoption Application Form

Our Pre-Adoption Team will review and process the application. Once the form has been processed, a team member will be in touch to set up a phone interview.
Perspective Pet Parent

First NameLast Name
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Birth Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are there children in the home? (If yes, please list ages)
Name of Pet You Wish to Adopt
What is your reason for wanting to adopt a dog?
If other, please explain:
How many total hours will your new pet be left alone during the day?
How many total hours will your new dog be outside alone during the day?
If adopting a puppy, where would the puppy be kept when alone?
Will you crate your pet?
Where will your new pet eat?
Where will your new pet sleep?
Do you own any pets?
Pet Name(s)
Pet Breed(s)
Pet's disposition and behavior towards other dogs?
When did you adopt your current pet(s)?
Veterinarian Name

First NameLast Name
Veterinarian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are your present pets up-to-date on their annual vaccines?
Do you have your pets on heartworm, flea and tick preventatives?
Are your present pets spayed or neutered?
If no, please explain:
Do you own or rent your home?
If you rent, what is your landlord's pet policy?
We require a letter signed from your landlord given permission to have a pet at their property.
Please provide your landlord's information here:
Do you have a yard?
Do you have a fenced-in yard?
What type of fencing?
We require homes have a fenced-in yard or play area for dogs to run and play in safety.
What are your plans for your pet when you are on vacation?
If you have to leave town, emergently or planned, where would your pet stay?
Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?
How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?
3 Personal References
Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?
Please provide a detailed description:
- By clicking the submit button, I agree to the adoption process, I agree to undergo a home check, and interview.
- By clicking the submit button, I understand my references will be checked including veterinary and personal.
- By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
- By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Rocky & The Bark Bunch.
- By clicking the submit button, I verify all of the above information is true and accurate.
Please remember, it may take two to three business days for processing and for us to get back to you.

- Rocky's Team
Date

MonthDayYear
Date
Signature of Potential Pet Parent
Should be Empty:

Rocky & The Bark Bunch Rescue Pet Adoption Application Form

Please remember, it may take two to three business days for processing and for us to get back to you.