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Pet Adoption
Pet Adoption
Dog / Cat Name You are Interested In
Date of Application
Your Name
(Required)
Home Address (include city and zip)
(Required)
Home Phone
(Required)
Alternate Phone
Work Phone
Email Address
(Required)
Driver's License or State ID
Birthdate
Employment
Employer Name and Address
Position
Length of Time With Employer
Does Your Position Require Travel?
Yes
No
Would you like to be included in Friends of Chicago Animal Care and Control mailing list?
Yes
No
Housing
Type of Housing
House
Apartment
Condo / Townhouse
How long have you lived at this address?
Are there any restrictions as to the number or size of animals you have?
Please provide contact information for landlord or association or a copy of your lease.
Please list all other members of the household, their age, and relationship to you:
Have you consulted and received approval with all members of the household regarding this adoption?
Yes
No
Have all household members interacted with the animal?
Yes
No
Does anyone in your household have animal-related allergies?
Yes
No
Which member of the household will be the primary caretaker of the animal(s)?
Name and contact information of your current veterinarian
Please provide contact information for 3 personal references. At least one reference should be a family member.
Reference #1
Name, relationship, phone and email
Reference #2
Name, relationship, phone and email
Reference #3
Name, relationship, phone and email
Where will your pet be kept in your home during the day?
Where will your pet be kept in your home at night?
How many hours will the animal be home alone during a typical day?
Why would you like to adopt a dog/cat?
Provide information regarding your pet(s) past and present (NOT including family pets from childhood):
Pet #1
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?
Pet #2
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?
Pet #3
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?
Pet #4
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?
Pet #5
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?
Pet #6
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?
Pet #7
Name, Species/Breed, Age, Sex, Altered?, current on vaccinations, where are they?