NEEDY PET DRIVE APPLICATION 2019

Needy Pet Drive Application 2019

Date: Saturday, December 14, 2019

Time: 1:30 pm - 4:00 pm

Where: BARk Headquarters, 1700 W Philadelphia St, York PA 17404

BARk has established a Needy Pet Drive for the purpose of providing pet supplies to needy animals in West York Boro as well as surrounding areas. Our desire is to help your pets. In order to assure that we are servicing you and your pets in the best manner, we need to understand you and your circumstances. Your information will only be used by BARk in order to determine if you are eligible for assistance.

1. Applications must be turned in no later than Thursday, December 5th.

ONLY ONE APPLICATION PER HOUSEHOLD PLEASE.

2. Please fill out the below application and submit. We will contact you once your application is approved.

3. You must present a photo ID to pick up your donation. If you need someone else to pick up your donations, they must have a photo ID or they can not receive your donations- no exceptions.

4. Pick up times are 1:00 pm to 4 pm at BARk Headquarters- 1700 W Philadelphia Street, York PA 17404 (The old West York Police Station) on Saturday, December 14.

5. If you have any questions, please contact us at

smetzler0725@comcast.net

Needy Pet Application 2019

One application per household

First Name

Last Name

Phone

Address

Name of person picking up donation

Pet name, type of pet (dog/cat), breed and age- please list all pets

Does your pet have any special needs/allergies?

By checking this box, I certify that the above information is true and complete to the best of my knowledge. I give permission to West York BARk to make inquiries as needed to determine if they are able to assist me.

Disclaimer-all items from BARk have been donated from outside sources. This includes, but is not limited to: food, treats, toys, medications, litter, and any pet supplies from our pantry. BARk is not responsible for any illness, reaction or harm your pet may incur from any item(s) received from our pantry. By checking this box, I understand BARk's hold harmless policy.

Thanks for submitting!