Bare Paws Rescue, Inc.

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Cell Phone

Marital Status:

If married, what is your spouse's full name?

If married, does your spouse know of and approve of you volunteering?

Are you employed? If yes, what is your occupation?*

What is your age?

Have you applied to any other rescues?

If yes, which one(s) and what is the status of your application?*

Do you have children?

If yes, children's ages?

How many people reside in your household?*

In what type of home do you live?

Do you own or rent your home?

If you rent, please enter your landlord's name and phone number:

List all current dogs (breed, age):*

List all other pets:*

Please describe the last dog you owned (prior to your current dogs):*

Why is the dog no longer with you? Please be specific:*

Are all pets up to date on vaccinations?

If not, why?

Are all pets spayed or neutered?

If not, why?

Are all dogs on heartworm preventative?

If not, why?

Where will the animal sleep?*

How many hours a day would the foster dog be alone?*

Where will the animal be kept when you are not home?*

Have you ever given up a pet? If yes, please explain:*

Do you have a fenced yard?

If yes, please describe the fence (height, type, etc):

Is the fenced area completely secure?

Do you have a dog door?

Are dogs allowed to go outside alone?*

Do you breed dogs?

Veterinarian's Name: *

Veterinarian's address:*

Veterinarian's Phone Number:*

If you have been using your current veterinarian for less than one year, please provide your previous vet's name, address and phone number:

Please provide 2 personal references who are not related to you: Name and phone number of reference #1:*

Name and phone number of reference #2:*

If approved, in what areas are you interested in participating?
Choose all that apply: Fostering Transports Fundraising Shelter contact Application screening Home visits

Bare Paws Rescue reserves the right to deny any application without explanation. Incomplete applications will not be processed. Please type your name in the box to acknowledge that you have submitted this application and that the answers are truthful. Please note that any application that does not meet the requirements as stated in our adoption guidelines will NOT be processed or acknowledged. Sign your name:*