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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
.
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:
*
Dog
Puppy
Cat
Kitten
Bird
Other
Applicant / Co-Applicant Information:
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?
*
If yes, this does not disqualify you, we just want to be aware.
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 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
[object Object]
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:
Pet #1 Name:
*
Pet #1 Type/Breed:
*
Pet #1 Gender:
*
Male
Female
Pet #1 Age:
*
Pet #1 Spayed / Neutered?
*
Yes
No
Where is this pet now?
*
Pet #2 Name:
*
Pet #2 Type/Breed:
*
Pet #2 Gender:
*
Male
Female
Pet #2 Age:
*
Pet #2 Spayed / Neutered?
*
Yes
No
Where is this pet now?
*
Pet #3 Name:
*
Pet #3 Type/Breed:
*
Pet #3 Gender:
*
Male
Female
Pet #3 Age:
*
Pet #3 Spayed / Neutered?
*
Yes
No
Where is this pet now?
*
*
Indicates required field
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?
*
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