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.

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.

Animal's Name(s): *

Type of Animal: *

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? *

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

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:

Do you have additional pets to list? (Our adoption counselor will ask you for details.) *

Yes No

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? *

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