Almost Home Dog Rescue Online Adoption Application

Thank you for your interest in rescuing a dog and for taking the time to complete this application. We appreciate your honesty in answering all of the following questions. Incomplete applications will not be considered. Review of the information you provide will assist us in matching the appropriate dog to your lifestyle. Our main concern is the future health and well being of all the animals in our care. Please note that we require that all applicants be at least 21 years of age, and we do not adopt outside the state of New Jersey.

Date:          Name of dog you are interested in adopting:

PERSONAL INFORMATION:

Your Name:        Spouse's Name:

Address:      City, State Zip:

Phone (Home):     (Cell):     Email:

Occupation:        Spouse's Occupation:

EMPLOYMENT:

Your Employer:      Address:

Phone:      Position:     Years there?

Spouse's Employer:      Address:

Phone:      Position:     Years there?

RESIDENCE:

I/we live in a      Rent or own?      Landlord's name:

Landlord's phone number:      May we contact?

If you rent, you must provide your landlord's contact information so that we may verify that you
are allowed to have a dog and we must also see a copy of your lease stating that dogs are allowed
prior to finalizing an adoption
.

How long have you lived at your current address?

If you have to move where dogs are not allowed, what would you do with this dog?


Please provide the names, ages, and relation to you of all other people living in household:


ANIMAL HISTORY:

Is this your first experience with a dog?

Reason I am interested in this particular dog:

Please explain why you feel this breed or mix is compatible with your lifestyle and experience:


Is this dog for your family?      Do all members of your household want this dog?

Is this dog a gift?            If yes, for whom?

Who will be primarily responsible for the dog?

Are all members of your household aware that you are adopting a dog?

Do any family members have allergies?      If yes, please explain:

What pets do you own now and where are they kept?  Please provide specific breeds, ages, sex,
how you acquired, and how long you have owned these pets.


Are they all:  Spayed or neutered?    Current on shots?    Licensed?

What pets have you owned in the past and where are they now?


Have you ever surrendered a pet to a shelter or given one away?    If yes, please explain:

CARE OF THE PET:

This dog will be kept in:      Do you have a yard?

Do you have a fence?      If yes, height?      Type?     

How large is the fenced-in area?


If you don't have a fence, how will you keep your dog at home?


Please explain how and when you will exercise the dog and allow it to relieve itself:


Do all adults work full time?    How long will the dog be left alone each day?

Where will the dog be kept during this time?

How many hours will you spend with your dog each day?

Where will the dog sleep?

TRAINING

Have you ever trained a dog before?

If yes, please describe the training methods you used:


Would you attend obedience classes with this dog?     

If no, or not sure, please explain:


Are you familiar with:

Housebreaking?
   Crate training?      Local dog licensing laws?

It may take your new dog a month or longer, especially if other pets are involved, to adjust
to a new home.   How will you handle this?



Which of the following potential behavioral issues are you willing and prepared to deal with?

House training:   Barking:   Chewing:   Digging:

Fear of men   Fear of women:   Dominance:   Aggression:

Separation anxiety:   Possessiveness:   Other destructive behavior:

How will you reprimand your dog?


Are you willing to seek professional help if behavioral issues arise in this dog?

If no, or not sure, please explain:

REFERENCES:

Veterinarian you have used before or plan to use for this dog:

Name:     Address:     Phone:


Name that vet records would be under:

Please provide 3 personal references, other than family members:

Name: Phone: Relationship:
Name: Phone: Relationship:
Name: Phone: Relationship:

Who will care for this dog if you are no longer able to?

Name: Phone: Relationship:

DONATION:

We require a non-refundable adoption fee of $350. This fee will be used to help our rescue efforts and for veterinary care. Please realize that dogs need vet care throughout their lives, including yearly boosters, heartworm and flea/tick preventatives, etc. If you cannot afford this fee, can you afford the appropriate vet care? Please consider this before adopting.

Are you willing to allow us to make a home visit to verify your application?

Are you willing to agree to 3-month, 6-month and yearly follow up visits?

Do you agree to contact us immediately if, for any reason, you are no longer able to keep this dog?

Please add any additional information that you think we should know about:


Please take a moment to be sure that all information is complete and accurate. Incomplete applications will not be considered. By clicking the submit button below, you are certifying that the information provided is complete and correct to the best of your knowledge, and you authorize AHDR to contact any individual listed on this application.

It should be understood that applications for dog/puppy adoptions are subject to acceptance based on a review process that may require collecting information from references. Decisions on placing dog/puppy in adoptive homes is an 'art,' not a 'science' and there might be times when applications will be denied for various reason(s). Almost Home Dog Rescue (AHDR) of NJ reserves the sole and exclusive right to make all decisions regarding placement or final disposition of any rescued dog in its care whether in, or being placed in, a foster or adoptive home or other facility. There is absolutely no guarantee made or implied that any person or persons requesting to adopt a dog through Almost Home Dog Rescue (AHDR) of NJ, or Almost Home Dog Rescue (AHDR) of NJ's website, will be granted an adoption.

I certify that the information provided is complete and correct to the best of my knowledge. I understand that Almost Home Dog Rescue (AHDR) of NJ reserves the right to contact any individual listed on this form. These terms acceptable to me, which I have indicated by clicking the submit button below: