QUARTERLY PET FOOD/SUPPLY APPLICATION

Quarterly Pet Food/Supply Application

BARk has established a BARk Food Pantry 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. **We cannot supply food for feral cats! We can only supply food/supplies for house cats!**

**You may receive food/supplies from BARk 4 times per year (once every quarter). This form MUST be filled out every quarter in order to receive food/supplies quarterly.**

1. Please plan on approximately 5 business days from submission of application until your food/supplies will be ready for pick-up.

2. *ONLY ONE APPLICATION PER HOUSEHOLD PER YEARLY QUARTER PLEASE.*

3. Please fill out the below application and submit. We will contact you via email once your application is approved. This email will include the pick-up date and times for your items.

4. Pick-up will be at BARk Headquarters located in the West York Municipal Building at 1381 West Poplar Street, York, PA 17404 (in the alley behind the building).

5. You must present a photo ID to pick up your donation. If you need someone else to pick up your donations, they must be listed as the pick-up person on the application and have a photo ID or they can not receive your donations- no exceptions.

6. If you sell anything given to you by BARk, you will be prosecuted by law for fraud. You or any representative for you will no longer receive anything from BARk in the future.

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

smetzler0725@comcast.net

Quarterly Pet Food/Supply Application

*ONLY 1 APPLICATION PER HOUSEHOLD PER YEARLY QUARTER*

Your first name

Your last name

Address

Name of person picking up donation

Your email

Your phone number

Please list pet name, type of pet (dog/cat), breed, age and any special needs/allergies. PLEASE LIST ALL PET

Additional comments

By checking this box, I agree that I will not sell any food/supplies that are given to me by BARk for monetary gain and I certify that the statements made above are 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 panty. BARK is not responsible for any illness, reaction, or harm your pet may incur from any item(s) received from our pantry. By submitting this form I accept and understand BARk's hold-harmless policy.

Thanks for applying! Once we review your application, we will send you a confirmation email with pickup information.