Personal Information

Name of Pet You Are Interested in Adopting

Name

First Name

Last Name

Email Address

Date of Birth

YYYY

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How long have you lived at this address?

Do you...

Is your home...

Current Landlord

* If currently renting we will contact landord for consent to allow pet adoption.

Landlord Name

Landlord Phone

(###)

###

####

Employment

Current place of employment

Work Phone

(###)

###

####

Other Members of Household

Partner Name:

Partner's Employment

Partner's current work phone

(###)

###

####

Children living in household (include ages):

Others in the household:

Who will have the major responsibility for this pet?

The reason(s) you wish to adopt a pet:

OTHER PETS in household

Pet 1: Name and Breed

Pet 1: Age

Pet 1: Weight

Pet 1: Spayed/Neutered

Pet 2: Name and Breed

Pet 2: Age

Pet 2: Weight

Pet 2: Spayed/Neutered

Pet 3: Name and Breed

Pet 3: Age

Pet 3: Weight

Pet 3: Spayed/Neutered

Other Information

Have you adopted from us before?

If yes, when?

If yes, who did you adopt?

If yes, what happened to the pet?

Veterinarian

Veterinary Clinic/Veterinarian Name

Veterinarian Phone

(###)

###

####

Do you have a current record with this Vet?

Date of last visit

YYYY

Where will this pet spend its time during the days?

Where will this pet spend its time evenings?

Where will your new pet sleep?

FOR DOGS: Is your yard completely fenced?

Type of fence?

How high?

Final Stretch

How did you find out about Animal Lifeline of Iowa?

If your new pet were a breed that may be a candidate for cosmetic surgery, would you have it done?

If so, please check the items that apply

Declaw

Ear Crop

Tail Bob

Other

Do you feel you can afford the cost of maintaining your pet, both now and for their lifetime (15+ years)?

Do you understand that there may be some adjustment problems, at first, which may require training and additional attention?

Are you able and willing to work with this pet in this regard?

I give Animal Lifeline of Iowa, Inc. permission to verify any and all information given by me on this application. I understand that any false information given will disqualify my application to adopt.

Applicant Digital Signature:

FOR OFFICE USE ONLY

Information below to be completed by ALI representative.

Today's Date

APPROVED______________

Animal Lifeline of Iowa

Animal Lifeline of Iowa (ALI) is Central Iowa’s only special needs, no-kill animal shelter, celebrating 30 years of serving the Des Moines area and all of Iowa. We rescue cats and dogs that are injured, handicapped, have a serious medical condition, abused, pregnant and nursing moms, or orphans that require bottle feeding. We rehabilitate the animals, who run a higher risk of euthanasia in a traditional shelter setting, and then adopt them into loving forever homes. Animal are not euthanized because they have been at the shelter for a certain length of time.

Get In Touch!

Shelter Street Address:
4521 SE 14th St,
Des Moines, IA 50320

Mailing Address:
PO Box 12, Carlisle, IA 50047

Shelter Phone Number:
(515) 285-7387

Shelter Hours:
Closed on all major holidays
Sunday - CLOSED
Monday - CLOSED
Tuesday - CLOSED
Wednesday - 12:00 PM - 5:00 PM
Thursday - 12:00 PM - 6:00 PM
Friday - 12:00 PM - 5:00 PM
Saturday - 12:00 PM - 4:00 PM
Appointments for adoptions are strongly recommended Wed. - Sat.
Please call 515.285.7387 to schedule an appointment.

Des Moines Animal Services
Animal Control for the City of Des Moines is overseen by
ARL Animal Services.
1441 Harriet St.
Des Moines, IA 50317
(new building on the corner of SE 14th St. & Harriett St.)
Hours:
Monday-Friday
9:30 a.m.-6:30 p.m.
Saturday and Sunday
9:30 a.m.-5:30 p.m.
Call: (515) 284-6905
Text: (515) 686-8274
Reporting an Animal Emergency:
If you are in Des Moines city limits, please call (515) 283-4811 to speak with DMPD dispatch, 24 hours a day, 7 days a week.