Almost Home Animal Rescue League Adoption Application

Online Dog and Cat Adoption Form

You understand and agree that by filling out this questionnaire/application, you are not guaranteed that this animal will be placed in your home for permanent adoption. You also understand and agree that Almost Home reserves the right to refuse any adoption application and that refusal is within the discretion of Almost Home. Questions marked with an asterisk (*) must be answered or the form will be rejected.

1. Animal's Name of Interest *
2. Is the animal a dog or cat? *
3. Applicant's First Name *
4. Applicant's Last Name *
5. Street Address *
6. City *
7. State *
8. Apartment Number (if applicable)
9. Zip Code *
10. Phone Number * Please use the following format 248-555-1212
11. Email Address * Please enter correctly as this is the main way we will contact you
12. Alternate Phone Number
13. Date of Birth * Please use the following format 10/26.63
14. Drivers License Number
15. How did you find out about Almost Home? *
16. Have you applied anywhere else for a pet? *
17. If yes, where else have you applied for a pet?
18. Is this pet for you or someone else? *
19. Do you own other pets at the current time? *
20. If yes, please list their names, breeds, and ages.
21. Are all of your pets spayed/neutered/fixed? *
22. How many pets have you owned in the last 5-10 years? *
23. What happened to them? *
24. Are your pets current on their vaccinations? *
25. Have you ever turned your dog or cat into a shelter? *
26. If yes, please explain?
27. Veterinarian's Name * If you have never owned a pet please tell us where you would go.
28. Veterinarian's Address, City, State, and Zip Code * Again if you have never owned a pet please list where you would go
29. Veterinarian's Phone Number *
30. Have you ever had a pet euthanized? *
31. If yes, please explain:
32. How do you feel about having pets spayed/neutered? *
33. Are you familiar with heartworm and heartworm prevention? *
34. If you have pets, will they adjust to a new pet in the house? *
35. Were any of your pets obedience trained? *
36. Please check the main reason you plan to adopt a pet:
37. If you answered "other" above, please explain here:
38. Please describe in detail the pet you are looking for. *
39. Do you own or rent your home? *
40. Please select your current residence type. *
41. If you answered "other" above, please explain here:
42. How long have you lived at this address? *
43. If you rent, does your landlord and lease allow pets? * Please note: You must provide Almost Home with a copy of your lease. If you live in a condo, we would like to contact the association to obtain permission for the animal to live in your home.
44. Including yourself, how many people live in your household? *
45. Please list the ages & relationship of those who live in your home. *
46. Is everyone in your household aware that you are planning to adopt a pet? *
47. Does anyone in your household have allergies to dogs/cats? *
48. Employment Status *
49. If you chose "other" above, please explain:
50. If you are employed, what is your current occupation? *
51. On average, how many hours per day will your pet be left alone and where will they be kept? *
52. How much do you think the annual medical bills will be for your pet? *
53. What would you do if the bills went over this amount? *
54. Will this pet be predominantly living inside, outside, or both? *
55. Please provide a description of this pet's living conditions. *
56. Do you have a completely fenced-in yard? If so, what kind of fence? *
57. If you answered "other" above, please explain:
58. If you do not have a fenced yard, how will you let the animal out? *
59. Are there times when the animal will be tied/chained up? *
60. If yes, when will they be tied/chained up?
61. Where will the animal sleep?
62. If you answered "other" above, please explain:
63. Will the animal spend any time in the garage? *
64. If the animal will spend time in the garage, please explain when/why: *
65. Do you have a pool? *
66. Is there a fence around the pool? *
67. What kind of fence do you have around your pool? *
68. If you answered "other" above, please explain:
69. How will you handle housebreaking? *
70. How will you handle destructive behavior? *
71. Will you keep the animal up-to-date on vaccinations and heartworm preventative? *
72. If no, please explain:
73. Are you willing and able to exercise the dog on a regular basis? *
74. If yes, what is the method of exercise? *
75. If you answered "other" above, please explain:
76. Have you ever been convicted of abuse or neglect of a child or animal? *
77. If yes, please explain:
78. If you drive a pick up truck, would you allow the animal to ride in the back/bed? *
79. What arrangements will you make for the care of your pets in case of an emergency? *
80. If you answered "other" above, please explain:
81. What will you do with the animal when you go on vacation? *
82. If you answered "other" above, please explain:
83. For what reason(s) would you consider returning/giving up the animal? *
84. What would you do with your animal if you had to move? *
85. If you answered "other" above, please explain:
86. Are you willing to take responsibility for this animal for the next 10-20 years? *
87. If no, please explain:
88. Will you allow Almost Home to preform home checks? *
89. If no, please explain why you will not allow a home check.
90. 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 Almost Home to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *

Almost Home – A Truly No-Kill Animal Rescue and Haven
PO Box 250602 West Bloomfield, Michigan, 48325
(248) 200-2695 FAX: (248) 234-8132