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*
Birth Date

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
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?

YesNo
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.
Are your present pets up-to-date on their annual vaccines?*

YesNoN/A
Do you have your pets on heartworm, flea and tick preventatives?*

YesNo
Are your present pets spayed or neutered?*

YesNoN/A
If no, please explain:
Do you own or rent your home?*

OwnRent
Please provide your landlord's information here:*
Do you have a yard?*

YesNo
Is it fenced? please describe*
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?*
What is your landlord's pet policy?*
Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*

YesNo
Are there children in the home? (If yes, please list ages)*
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?*

YesNo
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

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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.