SMALL ANIMAL ADOPTION APPLICATION


*You must be over 18 years of age to adopt*

Thank you for considering adopting a pet from our shelter! Remember that you are making a commitment that will involve several years. We will be happy to escort you through our facility to view the animals. Small animals cannot be viewed outside of their cages until you have been approved for adoption. Adoption fees are non-refundable. The animal must be taken to a veterinarian experienced in exotic medicine within seven days of the adoption for an exam.

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?

Animal 5:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

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

Animal 1:

Animal 3:

Animal 4:

Animal 5:

How many people are currently living in your home? *
Do you live in a single-family home, townhouse, condo, or apartment? *
Do you rent or own?*
If you own your home but the property tax bill appears in someone else's name, please list that here.

As you live in a Townhome or Condo, Animal Services will need a copy of your association by-laws.  If they are not available, we will request your association phone number to verify pets are allowed and check if there are restrictions.  

Does anyone in your household have allergies to hay or small animals?*

Caring For Your Small Animal:

Do you plan to let this animal outside?*
Do you have an exotic veterinarian that you plan on using?*

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