BARC Adoption Application
Please read our adoption policy before submitting an application:

If there is not enough space to fully answer each question, please send additional responses to
If you are applying to adopt a specific BARC dog, please name the dog.
Your Name *
Name of Co-Applicant
Address *
City *
Zip Code *
Phone *
E-Mail Address *
Place of Employment (self) *
How long have you been there? *
Do you plan on changing job soon? If so, please explain. *
Business Phone *
Place of Employment (co-applicant)
How long has he/she been there?
Does he/she plan on changing jobs soon? If so, please explain.
Business Phone (co-applicant)
Best time to reach you. *
Where did you hear about us? *
List all the people who live in your home and their ages: *
Do you live in a: *
If you rent or lease, do you have permission from your landlord to have a pet?
Clear selection
Landlord's Name and Telephone Number
How long have you lived at your current address? *
Do you plan to move within the next year? *
If so, what will you do with your pet? *
Are you aware that many insurance companies will not cover accidents involving breeds that they have deemed "dangerous", and pit bulls are listed among those. Those companies will refuse to continue coverage at the end of your term if they find out you own a pit bull; some will even drop you immediately. It is an unfair practice, but something we must consider before adopting one of our dogs out. To date only four of the major insurance companies do not discriminate based on breed: State Farm, Allstate, Farmers and USAA. If you have a different insurance carrier, we would need documentation stating they have no problem with you owning a pit bull type dog. Who is your current homeowners insurance carrier? *
If you are not applying for a specific dog, do you have a gender preference?
Clear selection
Preferred age:
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Indicate the energy level you are looking for in a dog. *
Please check the most important qualities you WANT in your new dog. *
Why do you think a BARC dog would be perfect for your family?
In the eyes of a dog, what's a typical day look like in your household? *
Who will be responsible for the care and cost of your new pet? *
What other pets do you have? Please list the type, age and activity level.
Where do they sleep?
Are they spayed/neutered?
Clear selection
If your animal(s) is/are not altered, please tell us why.
If your other pet is a dog, is it currently on heartworm preventative?
Clear selection
Do you have a fenced-in yard?
Clear selection
If so, what kind and how high is it?
Are you willing to reinforce/repair your fence if needed?
Clear selection
BARC does not advise taking pit bull dogs to dog parks. If anything negative were to happen, 9 times out of 10 it would be blamed on the pit bull (whether the dog started it or not). Are you willing to make sure your dog gets enough exercise and enrichment to meet their DAILY needs without frequenting to a dog park? *
BARC requires a home visit prior to adoption. We want to meet the whole family, make sure the dog gets along with everyone and that the home is safe and secure. Are you willing to have one our our volunteers bring the dog by for a visit? *
Do you travel much?
Clear selection
If so, who will take care of your pet while you are out of town?
Under what circumstances would you have to give up your pet? *
If you have checked behavior or other, please explain:
How do you plan to train your dog? *
Who will be responsible for the training of your dog? *
How will you correct inappropriate behavior? *
Are you willing to spend time training the dog to deal with problem behaviors such as jumping up, barking, pulling on the leash and/or separation anxiety? *
What behaviors would be difficult for you to tolerate or manage? *
Are you considering taking your dog to a formal obedience class? *
If so, we would be happy to point you in the right direction. Socialization classes are mandatory for puppies under 12 weeks, and group classes are encouraged for all dogs.
If the adoption counselor believes it is necessary, are you willing to purchase a dog crate? *
If not, please explain why:
Do you understand that your new dog will need to be checked annually for heartworms and continue preventative? *
Do you understand that your adopted dog will need periodic grooming to include: brushing coat, trimming nails, cleaning ears and teeth? *
Approximately how many hours a day will your pet be home alone? *
Where will you keep your dog during the day when you are home? *
Where will you keep your dog during the day when you are NOT home? *
Are you willing to keep a collar with a tag bearing your name, address and phone number on your dog at all times? *
Are you willing to accept immediate and full responsibility for the ownership and care of your adopted dog, including all health care costs and necessary burdens and responsibilities of owning a dog? *
Please list the pets you have owned in the past five years by name, breed, years in household and reason for death or leaving. Also, for those pets listed, please provide a vet reference if different from your current vet.
A BARC agent will be contacting the veterinarian(s) indicated on this application. Are you okay with us doing so? *
A dog can live 12 to 15+ years. Can you commit to caring for your new dog for that length of time? *
Please complete the following section if you or the co-applicant is in the military.
Current Duty Station
How long will you be in the military?
Do you currently live in base housing?
How long have you been stationed here?
How much longer will you live here?
Do you have to complete a tour of duty overseas?
Clear selection
If so, where will you be stationed and when will that take place?
What will you do with your dog if you are transferred overseas?
Are you expecting a state-side transfer?
Clear selection
If so, when and where will you locate?
What will you do with your dog if you are transferred state-side?
Did you have pets at your last duty station
Clear selection
If so, where are they now?
References: All applicants, please complete the following section:
Veterinarian's Name: If you don't currently have pets, who will you be using to care for your new dog? *
Is this your current vet? *
Phone *
Please list two references that you have known for more than two years, who do not live with you, and who can speak to your ability and commitment to providing a long-term, loving home for your new dog.
Personal Reference 1 Name *
Daytime Phone *
Evening Phone
Personal Reference 2 Name *
Daytime Phone *
Evening Phone
Estimate of Veterinary Costs:
Booster shots $40-60 (yearly)
Rabies $12-20 (yearly)
Office Visits $25-50
Heartworm Check $20-30 (yearly)
6 months heartworm preventative $40-45
6 months flea preventative $40-60
Emergency Vet Hospital $50-100+ per visit
Premium Dog Food $35+ per month
Boarding Charges $15-25 per day

Prices vary according to weight of dog and vet used and may have increased since this posting.
Adoption fees DO NOT cover the cost of caring and sheltering the animal you want to adopt. BARC agent will not be responsible for any medical care required by an animal adopted from us. You may return an animal for health reasons, but a refund on the adoption fee WILL NOT be given unless the return occurs within the first two (2) days following the adoption and your veterinarian has advised us of a medical condition identified during that two (2) day period. We hope this information doesn't discourage you from adopting from us, but reminds you that love comes with no guarantee.

Electronic contracts and electronic signatures are just as legal and enforceable as traditional paper contracts signed in ink. Federal legislation enacted in 2000, known as the Electronic Signatures in Global and International Commerce act (ESGICA).
Signature *
Signature (co-applicant)
BARC is a 100% volunteer operated rescue group . Please allow up to 48 hours for a reply. If no reply comes forth in that time, please feel free to email us at (Occasionally our "regular" life gets in the way of our "rescue" life and we can sometimes lose track of days!)
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