* = required field
Adoption requirements: (1) Be at least 21 years of age, (2) Have the consent of all adults living in the household, (3) Have approval from the residence owner, (4) Have valid ID with current address, (5) Be approved by Almost Home Foundation as a suitable adoptive home, and (6) Have a one-week trial to ensure the fit is satisfactory.
Driver's license #
Do you work full or part time?
How long have you been employed at your present job?
Do they match donations made to 501C3 non-for-profit YesNo
Residence Information (residency requirements will be verified)
Do you RENTOWN?
How long have you lived at your present address?
Any plans to move in near future?YESNO
Do you have a fenced yard, and if so, what is the height of the fence?YESNO
Number of adults
Their relationship to you
Number of children
Children's ages (in years)
Is this dog intended for your immediate family?YESNO
Person primarily responsible for your new dog
Any history of allergies in your family?YESNO
If so, what?
What is your family's current lifestyle: VERY ACTIVEACTIVEMODERATEOFTEN HOME
Number of hours you work per day
Number of hours your dog will be left alone per day
Pet history (for pets your currently own, or have owned in the past five years)
What inoculations has your current pet had in the last year?
Have you ever given a pet away or relinquished a pet to a shelter? YESNO
If yes, what were the circumstances?
Have any of your pets ever been (check all that apply)? LOSTHIT BY A CARPUT TO SLEEPGIVEN AWAY
If yes, what were the circumstances?
New pet information
Why do you want to adopt a pet? (please check all that apply) CompanionCompanion for another animalGiftTo breedFor a childTo teach responsibilityProtectionWatch Dog
How many times a day will you take your pet outdoors?
Will you take your pet to obedience class? YESNO
Where will the pet be kept when you are at home? INSIDEOUTSIDEGARAGE
Where will the pet be kept when you are not at home?
Do you plan on crating your pet?
If so, when, why, and for how long?
Are you aware of the general pet care costs (food, inoculations, medical care, boarding, incidentals)? YESNO
Do you travel often with work or vacation? YESNO
How often? WEEKLYMONTHLYYEARLY
Who will care for your pet in your absence?
What kind of ID will be kept on the pet?
How much time are you prepared to allow the pet to adjust to your home?
What will you do in the event of:
In case of emergency, who will care for the pet
What veterinarian (or hospital) have you used or are going to use?
Are you aware of the licensing regulations and fees in your village?
Do you know the leash laws of your area?
Are YOU aware of the grooming costs for the breed that you are considering for adoption?
Please list 3 personal references along with phone numbers (neighbor, friend, relative):
How did you hear about Almost Home Foundation?
If it was a newspaper, which one?
Would you like information on becoming an Almost Home member? YESNO
Do you have any question or concerns?
l,the undersigned~ certify that the information provided in this application is complete and accurate to the best of my knowledge. I understand that any misrepresentation of facts will result in my losing the privilege of adopting an animal from Almost Home Foundation. I realize that Almost Home Foundation has the right to deny my request to adopt an animal~ either because the individual animal is not suita.ble to my circumstan~ or on a more general basis. I understand that this application becomes the property of Almost Home Foundation, and all information given herein is for Almost Home Foundation's use alone. I~along with those persons accompanying me, assume risk of injury which may be incurred as a result of my viewing any animal under the care of Almost Home Foundation.