BARRC Expression of Interest

Thank you for your interest in adopting a rescue dog! To ensure the best match for both you and the dog, please complete all fields in this form. Incomplete forms may not submit successfully. Before you begin, please ensure you have clear photographs of your property, including: Fencing and gates, Shelter (e.g. patio, verandah) These photos help us assess suitability and speed up the adoption process. We appreciate your support in giving a rescue dog a loving home!
Note that all fields marked with an asterix (*) are required to be completed to ensure your form submits successfully.
Details of Animal you are expressing interest in
BARRC Dog Name *
Animal ‘D’ Identification Number *
Your Details
Please select *	Mr Mrs Miss Ms
Applicant's First Name *
Applicant's Surname *
Year of Birth *
Email Address *
Mobile Phone *
What is your preferred time/day for a BARRC volunteer to ring should we need to contact you for further information?
Street Address *
City *
State *
Post Code *
Name of Shire/Municipality you reside in (for registration purposes) *
Occupation *
Are there any delays in your availability to adopt now? * If yes, please provide further information. Otherwise, comment with No
Please provide contact details of a friend or family member for microchipping purposes. (Microchips require a second contact option when registering)
Full name of Secondary Contact *
Phone number for Secondary Contact *
Do you have previous dog ownership experience? *
Are you looking for an adult dog or puppy? *
If you are considering a puppy, have you considered what he/she will be like when fully grown? (eg exercise level requirement, size etc) • Do I want a puppy or an adult dog? • Can I cover all the financial costs of owning a dog, beyond the adoption fee, including food, toys, annual vaccinations; vet checks; monthly flea/worm treatment and possibly pet insurance? • Do I have time to train and socialise a dog? • Will I have time to walk and play with a dog (approx 1 hour per day)? • If renting, can I provide written permission from my landlord to have a dog and what happens if I move? • Am I ready to take on a 15 year commitment?
Please note that when adopting a puppy from BARRC, it is a mandatory requirement that the pup is sterilised at an agreed upon age (between 6-12 months) depending on breed size. This service is inclusive of the adoption fee when using one of the vet clinics listed here. Please select your preferred vet if applying for a puppy under 6 months of age.	Blair Street Vet - Bunbury Bunbury Vet Clinic - Bunbury Collie Vet Services Eaton Pet Vet - Eaton Eaton Vet Clinic - Eaton Heritage Vet - Busselton Larkhill Vet - Port Kennedy Ocean Keys Vet - Clarkson
Please select all relevant options	Must be compatible with young children Must be compatible with household dog Must be compatible with all dogs Must be compatible with cats Must be compatible with livestock Must be compatible with chickens
Are you looking for a specific breed? If yes, please list * Please provide information on your preferred breed/s and any breed you are specifically not interested in adopting.
Are you looking for a male or female? *
What size dog are you looking for? *
Any other preferences? (eg short hair)
Tell us a little about the type of personality you are seeking in a companion dog and what daily activities you intend to include your dog in. *
Describe your lifestyle. *
Who will this dog be sharing the home with? Please list adult members of the house hold. This ensures the dog will be comfortable sharing the space with other adults male/female. *
Will there be children living or visiting the home with the dog? This includes split custody, nieces and nephews or grandkids. *
Please provide further information including ages of children. If not relevant,enter N/A *
Your Property
Do you own or rent your home? *
If renting, do you have written approval for this dog? *
If renting, please provide more information on duration of lease, how long you have been at the property, how you intend to provide for a dog if you are needing to move residence.
Please describe the type/materials and height of your fencing and gates. *
Is your yard considered (select one) *
Please describe available shelter for protection from hot/cold/wet weather on your property eg Patio, kennel, purpose built enclosure, dog door *
Please provide photographs of your property boundary fencing, shelter and gates. *3 photos are required as a minum for this application to proceed. Please NOTE that if you do not have access to property photos at time of submitting this application, attach 3 other photos of your choice. Should your application be successful, we will be in touch to request photos at the time, hence a slight delay in your application proceding.
Property Photo *
Property Photo *
Property Photo *
Property Photo
Property Photo
Property Photo
Your Current Pets
Will this dog be sharing the home with other pets? *
Pet 1 Information * Please provide Name, Age, Sex, Size/Breed of animal If you have no other animals - simply type N/A
Pet 2 Information
Pet 3 Information
Pet 4 Information
Pet 5 Information
Other Animals On The Property Will this animal be sharing the property with horses/cattle/sheep/chickens?
Are your current pets desexed? *
Are your current pets fully vaccinated? *
Are you aware that all dogs must, by law, be registered with your local shire? *
If you are enquiring for a third dog, have you been approved by your shire? *
Pet Care
Tell us a little about your lifestyle and what form of exercise you will offer this dog and how often? * Please provide detailed information on amount of exercise you can provide for the animal daily/weekly and the type of exercise (eg dog park, beach, bush walks, farming,etc)
How will you socialise this dog with other animals? * Have you considered how to manage unwanted behaviours? Please provide detailed information on how you intend to socialise and train this dog. Dog Club/Training,local dog park, friends and families pets, etc
Are you willing to provide obedience training for your new dog if needed? *
How many hours in a typical day will this dog be left alone without people company? *
Will this dog be indoors or outdoors *
Have you considered the financial costs involved in dog ownership. Eg Annual vet checks/vaccinations, grooming, unexpected veterinary costs, dietary requirements, training costs? *
Have you given thought to 5-10 years time and how this dog relates to your future plans? *
If you were to go on holidays what plans do you have for your dog? *
The more information you can provide, the greater chance BARRC have at finding your a perfect match. Please tell us anything else you consider we would like to know *
Where did you hear about BARRC? * Select one of the options
Which advertising platform did you apply for this dog through? *
*	(Check box to proceed) I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. I am aware that BARRC cannot guarantee the health and temperament of the animal.