Chicago Pet Rescue - Adoption Application

Please fill in the form below and click "submit." If you would prefer to download this application, click here. Downloaded applications can be emailed to followup@chicagopetrescue.org or printed, mailed or brought to one of our adoption events.

We respond quickly to applications so please check your Spam or Junk email folders to prevent missing our response.

Application REQUIREMENTS:

Primary applicant must be 21 years of age or older and all current pets must be fixed/up to date on shots.

If you rent, own a condo or have other pets - please notify your landlord/condo association/vet that we will be calling them, before submitting this application then include their name and number below.

NOTE: The majority of adoptions do NOT occur same day. For all animals, we schedule an initial meet/greet within a half hour of Chicago zip code 60631. For dog applicants we require a home visit after your initial meet/greet so you must live less than 1 hour. There is no guarantee that an adoption will happen the same day or at all. If you live further then 1 hour we recommend you understand and are ok with coming out and possibly not adopting or having to come back a second time.

For most KITTENS under 4 months we require they be adopted in pairs or separately (if another cat or kitten already lives in the home).

Animal's Name(s): *

Type of Animal: *

Applicant / Co-Applicant Information:

* Indicates required field

Applicant's Name: *

First

Last

Applicant's Date of Birth: MM/DD/YY *

Co-Applicant's Name: *

First

Last

Co-Applicant's Date of Birth: MM/DD/YY: *

Primary Phone Number: *

Second Phone Nummber: *

Third Phone Number *

Primary Number is: *

Home Mobile Work

Applicant's Email Address: *

How were you referred to Chicago Pet Rescue? *

Are you considering adopting other animals at the same time? *

Why did you pick this animal? *

Applicant's Address *

Line 1

Line 2

City

State

Zip Code

Country

How long have you lived at this address? *

Do you have Homeowner's or Renter's Insurance? *

Do you rent or own? *

Rent Own

Landlord or Condo Board Contact: (If you rent or own a condo - please notify your landlord/condo association first and include their name and number below. *

First

Last

Contact Email Address: *

Contact Phone Number *

Do you plan to move in the near future? *

Yes No

If "yes", what do you plan to do with your pets? *

Family / Household Information:

How many adults are in the household? *

What are their relationships? *

How many children live in the household? *

What are the children's ages? *

Have the children had pets before? *

Have all of the adults in the household agreed to adopt this animal? *

Yes No

Is anyone in the household allergic to pets? *

Yes No

If "yes", who is allergic and how do you manage it? *

Current Pet Information:

Please tell us about your current or past pets and provide Vet information below:

Please list any additional pets (including name and what type). (Our adoption counselor will ask you for details.) * *

Have you ever given an animal away or relinquished an animal to a shelter? *

Yes No

If "yes" what were the circumstances? *

Veterinarian Information:

If you currently have or had pets in the past, please notify your Vet first that we will be calling and provide the information below.

Veterinarian's Name: *

Veterinarian's Phone: *

When was your current pet's last visit to a veterinarian and why? *

Additional Vet information: *

New Pet Information:

Why are you interested in adopting? *

Where will the animal be kept during the day? *

During the night? *

How many hours per day will the animal be left alone? *

How long have you been looking for a pet? *

Will this be your first pet? *

Yes No

Who in the household will be the primary care giver for the animal? *

How do you plan to house train your adopted pet? *

What will you do if your adopted pet develops a problem with any of the following behaviors?

Digging/Scratching: *

Barking /Hissing: *

Biting/Chewing: *

Aggression: *

Marking: *

Why do you want to adopt a pet at this time? *

What room/space do you plan to use as a starter room/separation area for your new animal for the first week(s)? Especially if you have other animals. *

Animal Care Experience

What are possible scenarios that would cause you to give up a pet? Please describe: *

Are there any behaviors you're NOT willing to work with? Please describe: *

Electronic Signature:

Typing your name and the date below will serve as your electronic signature.

Name *

First

Last

Today's Date: (MM/DD/YY) *

You must agree to the following statement: *

I certify that the information I have given is true. I understand that Chicago Pet Rescue reserves the right to deny my application for any reason. I further authorize the investigation of all statements in this application.

Please print a copy of this application before pressing Submit: (If you don't get acknowledgement of this application within 24 hours, please check your spam or send an email to followup@chicagopetrescue.org).

Submit your adoption application to Chicago Pet Rescue