Windy City Canine Rescue Adoption Application

In order to be considered for an adoption you must:

Be 21 years of age
Have the knowledge and consent of all adults living in your household
Complete the application FULLY. If the application has not been fully completed, we will NOT consider your application, nor will we respond to your application. We just don’t have the time/resources to do so.
Understand that completing this application does not guarantee adoption and that Windy City Canine Rescue must approve your application.

Is there a specific dog you are interested in?*

Your Full Name (Please include all adults in the the home, ensure you include last names )*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number - home

Area CodePhone Number

Phone Number - work

Area CodePhone Number

Phone Number -cell*

Area CodePhone Number

E-mail*

example@example.com

Do you...*

Attend SchoolWork

Do you...*

RentLive with ParentsOwn

Do you live in a...*

HouseCondoApartmentMobile Home

Landlord's Name

Landlord's Phone Number

Area CodePhone Number

How long have you been at your current address?*

If less than 1 year, please list previous address and how long there.

Please provide the following information about your household:

Number of Adults*

Number of Children*

Ages of your children (if applicable)

Are all the household members aware of, and consent to, the adoption?*

YesNo

Who will be primarily responsible for the care (feeding, grooming, exercise and training) of your new pet?*

Please describe in the detail the personality and basic requirements of the dog you are looking for:*

Why would you like to adopt a dog from us? Please check all that apply.*

How may dogs do you currently have?*

How many cats do you currently have?*

How many pets have you had in the last 5 years?*

Please list any pets you currently have, or have had in the past. We want to know: their name, type/breed, age, sex, a little about their personality, whether they are/were spayed or neutered, why you no longer have them and where you got them from.*

Are your current pets up to date on their vaccines and other necessary pet care?*

Name and phone number of veterinarian has your pet's records (past and present)? *

Which veterinarian do you plan to use for your new dog?*

Do you giver permission for your veterinarian (past & present) to release any records and information regarding your pets (past & present)*

YesNo

Are you prepared for the expense of owning a pet? (Average is $1,500/year per dog)*

YesNo

Are you willing to accept financial responsibility of any unexpected/required medical expenses?*

YesNo

Have you considered or are you willing to get pet insurance?*

YesNo

Have you ever surrendered or given up an animal before?*

YesNo

If you answered yes to the question above, please explain the circumstances.

Are you prepared to allow an adjustment period for your new dog of at least one month?*

YesNo

If you have other pets, do you suspect they'll adjust OK to the new one?*

YesNo

Are you aware of the existing licensing/pet bylaws in your community?*

YesNo

What is your current occupation?*

Does your job require extensive travel?*

YesNo

Are any members of your household allergic to pets?*

Do you have any plans to move in the near future?*

If at some time you do move, what will you do with your pet?*

How much time per day will this dog be alone (without human companionship)?*

Will your dog stay:*

Primarily insidePrimarily outsideOutside only

Where will the dog be kept when home alone?*

How active do you want your pet to be?*

High energy/activeMedium energyLow energy/couch potato

How and where will you exercise this dog?*

How often will you exercise this dog?*

Who will watch your pet when you are away on vacation?*

Do you have a full fenced in yard? If so, how high is it?*

If your yard isn't fenced, how do you intend on keeping this dog home?

Are there times this dog will be tied up?*

YesNo

Do you have a dog house?*

YesNo

Would you consider obedience classes for this dog?*

YesNo

Where will the dog be when in a vehicle with you?*

What type of food will you feed this dog?*

How much grooming are you prepared to do?*

Very littleReasonableDemandingVery High Maintenance

Describe how you will housebreak a dog:*

Describe any circumstances in which you would consider returning the dog to Windy City Canine Rescue (i.e. new baby, moving, illness, etc) *

How will you handle behaviour problems such as chewing, excessive barking, etc.*

A dog can live well over 10 years and requires a major commitment of time, finances and emotion. Why do you feel you can make that kind of commitment at this time?*

Can you tell us a bit more about yourself and your family and why you think this dog would be suited for your lifestyle?*

If the dog you want is unavailable or not the right fit, are you open to suggestions for a different dog?*

YesNo

Are you interested in:*

FosteringAdopting

How did you hear about the Windy City Canine Rescue?*

Please list 3 personal references below including their name, their relationship to you and a phone number we can reach them at.*

By clicking "Accept" below, I certify that the information given is true and correct and I recognize that any misrepresentation of facts will result in my losing the privilege of adopting a pet. I also give my veterinarian permission to release any vet care records and information about my current and past pets to the Windy City Canine Rescue. I understand that this application is the property of the Windy City Canine Rescue and that the Windy City Canine Rescue has the right to deny my request to adopt.*

I accept the above termsI don't accept the above terms

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