Adopt-a-Dog – Will County Humane Society

Applicant(s) - Step 1 of 13

Applicant

Name *

First

Last

Maiden Name

Date of Birth *

Phone *

Can we text this number? *

Email *

Co-Applicant

Name

First

Last

Maiden Name

Date of Birth

Phone

Can we text this number?

Address

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Applicant

Employer *

Occupation *

Phone *

How many days a week do you work? *

How many hours a day do you work?

Selected Value: 0

Number of years at Current Employer *

Previous employer (if less than 1 year)

Co-Applicant

Employer

Occupation

Phone

How many days a week do you work? *

How many hours a day do you work?

Selected Value: 0

Number of years at Current Employer

Previous employer (if less than 1 year)

Have you ever completed an application at another animal shelter, or other rescue organization? *

Name of Animal Shelter or Rescue Organization

Animal Shelter or Rescue Organization Phone

What was the outcome of this application?

What is the total number of people living in your household?

Selected Value: 0

Please list the name, date of birth, and relationship of each person living in your household below

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

Name *

First

Last

Date of Birth

How long have you lived at your current residence?

Selected Value: 0

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Please answer all questions honestly

Does anyone in your home have pet allergies *

Has anyone living in your home ever been convicted of a felony? *

Do you own or rent your home? *

Own
Rent

Please select the type of residence that best describes your home *

Single Family Home
Condo/Townhome
Apartment
Mobile Home

Do you have a fenced yard? *

Yes
Partial
No

If yes, please describe your fence *

Material used, fence height, etc.

Why are you looking to adopt a dog? *

How would you describe your activity level? *

Low
Moderate
High

How do you plan to exercise your pet? *

How many hours will your pet be alone during the day?

Selected Value: 0

Where will your pet sleep at night? *

Do you plan to take your pet to basic obedience classes? *

Yes
No
Undecided

Do you plan to crate train your pet? *

What will happen to your pet if you move locally or out of state? *

The ASPCA estimates a yearly $1,300 in total care expenses for owning a dog. This includes things such as food, grooming, and vet care. This amount may increase if your pet becomes ill or injured. Are you willing to take on this financial responsibility *

What would cause you to return your pet to WCHS? *

Should behavior or training issues arise after you adopt your pet, are you willing to seek help from certified dog trainer or behaviorist and take financial responsibility for such services? *

Many Shelter pets require training classes and other resources to assist in the adjustment of entering a new home. How much money would you be willing to spend on such resources? *

Do you have the time, patience, and financial means to address unforeseen issues such as excessive barking, chewing, marking, or accidents in the house? Including digging, nipping behavior, mouthing, and separation anxiety? *

How many pets do you have in your home?

Selected Value: 0

Cats & Dogs

Pets Name

Species

Breed

Age

Gender

Male
Female

Fixed?

How long have you owned this pet?

Pets Name

Species

Breed

Age

Gender

Male
Female

Fixed?

How long have you owned this pet?

Pets Name

Species

Breed

Age

Gender

Male
Female

Fixed?

How long have you owned this pet?

Pets Name

Species

Breed

Age

Gender

Male
Female

Fixed?

How long have you owned this pet?

Pets Name

Species

Breed

Age

Gender

Male
Female

Fixed?

How long have you owned this pet?

Veterinary Clinic Name *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Veterinary Clinic Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Veterinary Clinic Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

How many pets have you previously owned?

Selected Value: 0

Pets Name *

Species *

Breed *

Age *

Gender *

Male
Female

Fixed? *

How many years did you own this pet? *

Why do you no longer own this pet? *

Pets Name *

Species *

Breed *

Age *

Gender *

Male
Female

Fixed? *

How many years did you own this pet? *

Why do you no longer own this pet? *

Pets Name *

Species *

Breed *

Age *

Gender *

Male
Female

Fixed? *

How many years did you own this pet? *

Why do you no longer own this pet? *

Pets Name *

Species *

Breed *

Age *

Gender *

Male
Female

Fixed? *

How many years did you own this pet? *

Why do you no longer own this pet? *

Pets Name *

Species *

Breed *

Age *

Gender *

Male
Female

Fixed? *

How many years did you own this pet? *

Why do you no longer own this pet? *

Veterinary Clinic Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Veterinary Clinic Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Veterinary Clinic Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Personal References

Please list (2) personal references who ARE NOT related to you and who knows, or has known, your pets both current and past. If you have never owned a pet, please list (2) personal references who can vouch for you.

Reference 1 *

First

Last

Phone *

Reference 2 *

First

Last

Phone *

Compatibility Questionnaire

Thank you for your interest in adoptiong your new companion from Will County Humane Society. Below will be a list of questions that will help our knowledgeable staff guide you towards a great fit for your household. Please answer the following questions as honestly as possible.

What are you looking for in your new companion? *

What kind of energy level are you looking for, and why? *

High activity, medium activity, low activity, etc.

What age range are you looking for, and why? *

Do you have an active household? *

If so, please explain:

Does your household have experience with rescue pets? *

Are you looking for a specific breed for your next pet? *

If so, please explain:

Our Goal

Here at the Will County Humane Society, we do our best to make sure each of our pets finds their forever home. We want to make sure the worst is behind them and that they live happily every after with their new families. We understand that there is an adjustment period for all pets and their families before everyone is on the same page. Each adjustment period will vary based on the pets personality and past. If approved, we will use the adoption screening form questionnaire provided to find your families perfect fit. Rest assured, if your new companion is not at our facility at the time of your visit, we will happily welcome you back at a later point in time.

Application Submission

By checking this box and submitting the application, you confirm that you have provided all the required information for the Will County Humane Society to complete all necessary screenings. *

I agree to allow Will County Humane Society to conduct all necessary screenings

Name