Adoption Application

You may download the application or can fill out the form below.

DOWNLOAD ADOPT A DOG APPLICATION

DOWNLOAD ADOPT A CAT APPLICATION

  • dog

  • cat


* = required field

Date*

Dog's name*

For FOSTER ADOPTION 

Store Location:

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.

Name(s)*

Driver's license #

Address*

City*

State*

Zip*

Home Phone*

Work Phone

Cell Phone

E-mail Address*

Do you work full or part time?

How long have you been employed at your present job?

Employer

City

Do they match donations made to 501C3 non-for-profit  Yes No

Residence Information (residency requirements will be verified)

Do you RENT OWN ?

APARTMENT CONDO TOWNHOUSE SINGLE-FAMILY 

OTHER

How long have you lived at your present address?

Any plans to move in near future? YES NO

Do you have a fenced yard, and if so, what is the height of the fence? YES NO

If renting,

Does your lease allow dogs? YES NO

Is a deposit required? YES NO

Is there a weight limit? YES NO

Is your landlord aware you intend to adopt an animal and have they given permission? YES NO

Landlord's name

Landlord's phone number

Name and address of housing complex

Did you bring a copy of your lease? YES NO

Household information

Number of adults

Their relationship to you

Number of children

Children's ages (in years)

Is this dog intended for your immediate family? YES NO

Person primarily responsible for your new dog

Any history of allergies in your family? YES NO

If so, what?

What is your family's current lifestyle:  VERY ACTIVE ACTIVE MODERATE OFTEN 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)

Name of pet Type/breed Sex Kept where (i.e., indoor, outdoor) Spayed/neutered? Still own? If no, what happened to the pet?

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?  YES NO

If yes, what were the circumstances?

Have any of your pets ever been (check all that apply)?  LOST HIT BY A CAR PUT TO SLEEP GIVEN AWAY

If yes, what were the circumstances?

New pet information

Why do you want to adopt a pet? (please check all that apply)  Companion Companion for another animal Gift To breed For a child To teach responsibility Protection Watch Dog

How many times a day will you take your pet outdoors?

Will you take your pet to obedience class?  YES NO

Where will the pet be kept when you are at home?  INSIDE OUTSIDE GARAGE

Where will the pet be kept when you are not at home?

Do you plan on crating your pet?  YES NO

If so, when, why, and for how long?

Are you aware of the general pet care costs (food, inoculations, medical care, boarding, incidentals)?  YES NO

Do you travel often with work or vacation?  YES NO

How often?  WEEKLY MONTHLY YEARLY

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:

Barking problems

Aggressive behavior

Chewing/Digging

Housebreaking problems

In case of emergency, who will care for the pet

What veterinarian (or hospital) have you used or are going to use?

Name:

City:

Phone:

Name:

City:

Phone:

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):

1:

Phone:

Relationship:

2:

Phone:

Relationship:

3:

Phone:

Relationship:

Almost Home:

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?  YES NO

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.

Signature:*

Date*