OLD Backup Chicago Pet Rescue - Adoption Application - Download OLD

Enter the name or names of the animal(s) *

Type of Animal *

Why did you choose this animal? *

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

How were you referred to Chicago Pet Rescue? *

If your application is approved within 1-2 days when are you ready to adopt? Please enter date when you can take pet home. And if date not within 1-2 day, explain why the need to wait? *

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) *

Applicant's Primary Phone Number *

Primary Phone Number is: *

Mobile Home Work

Second Phone Number *

Applicant's Email Address *

Do you own or rent your home? *

Own Rent

Applicant's Home 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? *

Yes No

If you rent or own a condo, please notify your landlord/condo association first and include their contact information below. *

First

Last

Landlord / Condo Phone Number *

Landlord/Condo Email Address *

Do you plan to move in the near future? *

Yes No

If you plan to move, what will do you with your pets? *

How many adults are in the household? *

What are their relationships? *

How many children live in the household? *

What are the children's ages? *

What experience has your family had with 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? *

Pet 1 - Name *

Pet 1 - Type / Breed *

Pet 1 - Age *

Pet 1 - Gender *

Male Female

Pet 1 - Spayed / Neutered *

Yes No

Pet 1 - Where is this pet now? *

Pet 2 - Name *

Pet 2 - Type / Breed *

Pet 2 - Age *

Pet 2 - Gender *

Male Female

Pet 2 - Spayed / Neutered *

Yes No

Pet 2 - Where is this pet now? *

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

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

Yes No

If "yes", what were the circumstances? *

Why are you interested in adopting a pet at this time? *

Where will the animal be kept during the day? *

Where will the animal be kept at 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

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

If you are applying for kitten/cat, have you ever declawed a cat or plan to do so in the future? If so, explain why? *

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

Who in the household will be the primary caregiver for the animal? *

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

Digging / Scratching *

Biting/Chewing *

Marking *

Barking/Hissing *

Aggression *

If you are applying for kitten/cat, have you let your current or past cat outside? If so, explain why? *

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/save a copy of this application before clicking "submit".
If you don't receive an email acknowledgement of this application within 24 hours, please check your junk mail folder or send an email to [email protected].

Application Requirements