Incomplete applications will be discarded

Please read and answer EACH question carefully.

Today's Date *
Today's Date
Applicant's Name *
Applicant's Name
Example: 56th Street and Cactus Rd
Home Phone
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Do you live in: *
Are you planning on moving within the next 6 months?
Do you own or rent?
If you rent, do you have permission to have a dog?
Do you have or are you planning on installing a doggie door?
May we visit your home before and after you adopt a dog?
Have you applied to foster/adopt with any other Rescue Organization within the past year? *
Please Enter their name, Phone Number, E-Mail address and the number of years you have been acquainted with them.
Are all of you current pets spayed or neutered?
In the past 5 years, have you had any other pets that are no longer with you?
Have you ever given up a pet?
How would you describe the physical activity level of your family?
How would you rate the social activity of your family?
Is anyone in your home allergic to animals?
Would you be willing to foster a dog that needed medication or special attention?

By returning this application, I am agreeing that the above information is true and correct and understand that this information will be included with my adoption contract and if found to be untrue at any time (even following adoption) the dog may be reclaimed at no expense to Almost Home Az Rescue.   Further, by applying for the adoption of a dog, I hereby give permission to my Veterinarian, my personal reference, and landlord (if applicable) to disclose information to Almost Home Az Rescue.