heading

This ADOPTION/FOSTER form must be completed in full to begin the adoption process with ALMOST HOME RESCUE. Please be as truthful and forthcoming as possible for us to help you determine whether a good match is likely. Each item of information on the application is important, and any omitted elements will be requested before the application can be processed. (This may also cause unwanted delays.)

If we do not receive a response for requested information, the application will be denied. All information is verified during application processing to ensure the safety and future well-being of every dog that is adopted. Our goal is to work closely with each potential adopter to ensure the best possible match based on compatibility of personality, environment, and lifestyle. Please help us help you!

TYPE IN YOUR ANSWERS ON THE FORM BELOW THEN CLICK YELLOW 'SUBMIT' BUTTON AT THE BOTTOM OF THE PAGE TO SEND THE FORM TO US.

Email Address Your Name Your Age

Street Address City State Zip Code

Home phone Cell phone

Names and ages of all other people in the house and relationship to you:

Name Relationship Age

Name Relationship Age

Name Relationship Age

Name Relationship Age

Name Relationship Age

Name Relationship Age


Where do you work? Work Phone

Where does your spouse work?

Is everyone in the family in agreement to adopting a new dog? Yes No

Who is home during the day?

Are there other small children that visit your family, such as grandchildren, etc.?

Name Relationship Age
Name Relationship Age
Name Relationship Age

Which dog are you interested in adopting? Breed

Have you ever owned a Jack Russell Terrier before? Yes No

Are you interested in fostering a dog for Almost Home Dog Rescue? Yes No


CURRENT PETS IN YOUR LIFE


Do you currently have pets? Yes No

Please list current pets:
Name Breed Age Size
Male Female Spayed or neutered? Yes No
How did you acquire pet?
Where did you get your pet? If 'rescued', which rescue or organization?


Name Breed Age Size
Male Female Spayed or neutered? Yes No
How did you acquire pet?
Where did you get your pet? If 'rescued', which rescue or organization?


Name Breed Age Size
Male Female Spayed or neutered? Yes No
How did you acquire pet?
Where did you get your pet? If 'rescued', which rescue or organization?


Name Breed Age Size
Male Female Spayed or neutered? Yes No
How did you acquire pet?
Where did you get your pet? If 'rescued', which rescue or organization?


Do you keep your pets outdoors or indoors? Indoors Outdoors

Do you keep your pets on heartworm preventative? Yes No

Are your pets up to date on their vaccines? Yes No


PREVIOUS PETS IN YOUR LIFE


Have you owned pets in the past? Yes No

Name Breed Age
Where did you get this dog?
How long was the dog with you?
What happened to this pet? (please tell us briefly in exact terms)


Name Breed Age
Where did you get this dog?
How long was the dog with you?
What happened to this pet? (please tell us briefly in exact terms)


Name Breed Age
Where did you get this dog?
How long was the dog with you?
What happened to this pet? (please tell us briefly in exact terms)


Have you ever surrendered a pet to a shelter? Yes No If 'yes', what were the circumstances?


YOUR HOME AND LIFESTYLE


How many hours a day would the dog be alone?
0-2 hours
2-4 hours
4-6 hours
6 or more hours


Do you have a fence? Yes No
If yes, what type? Wood Chain Link What height?
What is the size of your fenced area?

Do you have a swimming pool? Yes No

Does your dog have free access to the fenced yard through a DOGGIE DOOR? Yes No

Do you allow your dog to go outside alone without supervision? Yes No

Do you leave your dog outside when you are not at home? Yes No

Are you willing to crate train your dog? Yes No

Where will the dog sleep?

Do you own or rent? Own Rent How long have you lived there?

Type of Residence:

If you rent, please give your landlord's name and phone number:
Landlord Name Landlord Phone


YOUR VETERINARIAN

**Please list your current Vet and the Vet you have used for your dogs in the past. If this is omitted your application will be delayed in processing.**

Current Vet name Current Vet phone number
Pets on account at current Vet's office

Previous Vet name Previous Vet phone number
Pets on account at previous Vet's office




PERSONAL REFERENCES


Please give us two personal references to contact:

Name Phone
Name Phone

Anything else you want to tell us?