Poe's Pups Adoption Application

Please review the following points before pre-filling your application:
- Pre-filling this application does not place a hold on an animal or guarantee adoption.
- Once the application is submitted, you will be placed in contact with the foster family via email to learn more about the animal you are interested in!
- The majority of Poe's Pups dogs are in foster homes.* To meet dogs in foster homes, your application must be approved first. You will receive an email from our shelter when this step is complete. Please understand that this may take a few days and that filling out the application does not guarantee you will be able to adopt the animal.
  
  *If the dog you are applying for is not in a foster home, our team will contact you with next steps, which will require you to travel to our shelter.
- All adoption decisions are made solely by BARCS. The Baltimore Ravens are not involved in reviewing applications, selecting adopters, or making adoption decisions.

Name of the Poe's Pup I'm interested in is...
Today's Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Full name:
Legal First and Last Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
County of Residence (if Maryland Resident, otherwise 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
2 digit month, 2 digit day, 4 digit yearFormat: Month/Day/Year
Email:
example@example.com
Phone Number (Primary)

Area CodePhone Number
Primary Phone Number is a Cell?
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):

Other
I need more information on (check all that apply):

Other
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.
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:
Print Name
Signature
- Should be Empty: