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

Employer Name and Address

Position

Length of Time With Employer

Does Your Position Require Travel?

Yes

Would you like to be included in Friends of Chicago Animal Care and Control mailing list?

Yes

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

Have all household members interacted with the animal?

Yes

Does anyone in your household have animal-related allergies?

Yes

Which member of the household will be the primary caretaker of the animal(s)?

Name and contact information of your current veterinarian

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?