CHICKEN ADOPTION APPLICATION


Thank you for considering adopting a pet from our shelter! Remember you are making a commitment that will involve several years. We will be happy to escort you through our kennels to view the animals. Chickens can not be viewed outside of their cages until you have been approved for adoption. Our office will review your application to ensure you are allowed to house chickens per local ordinances. 

Applicant Information

Date*
Name*
Address*
How did you hear about us?

PLEASE LIST ANY PETS THAT ARE CURRENTLY IN YOUR HOME:

Animal 1:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 2:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 3:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 4:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

PLEASE LIST THE PETS YOU HAVE OWNED IN THE PAST FIVE YEARS:

Animal 1:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 2:

Animal 3:

Animal 4:

General Applicant Information

Have you ever owned a chicken before? *
Do you own your home or do you rent? *
Does anyone in your family have allergies to animals or hay?*

Caring for Your Small Animal(s)

Is your flock in an enclosed coop or free rang during the day?*
Do you have a predator-proof enclosure for your flock at night?*
If you do not have an avian veterinarian, do you need assistance finding one?*
Do you understand the special food this animal needs for a properly balanced diet?*
Would you like to review the animal's dietary needs during this interaction? *

By signing below, I certify that I am 18 years of age or older, the information that I have provided is true and that I recognize that any misrepresentation of facts may result in losing the privilege of adopting a pet. I authorize DuPage County Animal Services to investigate all statements made in this application.

Use your mouse or finger to draw your signature above
Date