Pet Adoption Application

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Please correct the field(s) marked in red below:

This form is used as the application that must be approved before adopting a pet from the St. Charles Animal Shelter. Please fill out this application completely. For more information on what is included with the adoption package, see this page.

Applicant

Applicant
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Applicant

Co-Applicant

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Co-Applicant

Home Information

Home Information

Do You Own or Rent?

Do You Own or Rent?

If You Rent, What is Your Landlord's Information?

If You Rent, What is Your Landlord's Information?

Do You Have Permission From Your Landlord to Have a Pet?

Do You Have Permission From Your Landlord to Have a Pet?

Does Your Landlord Have Any Size or Breed Restrictions?

Questionnaire (Complete answers to the following questions will enable us to become more familiar with you request and requirements and will help us find the right animal to match your needs and expectations.)

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Questionnaire (Complete answers to the following questions will enable us to become more familiar with you request and requirements and will help us find the right animal to match your needs and expectations.)

Would you consider a pet with special needs, such as one who requires medication for a permanent but controlled condition?

Would you consider a pet with special needs, such as one who requires medication for a permanent but controlled condition?

Do all members of your household share your interest in adopting a pet?

Do all members of your household share your interest in adopting a pet?

Your age and the ages of all others living in your home

May we visit your home prior to your application being approved?

May we visit your home prior to your application being approved?

If yes, when is best?

Any objections to followup visits?

Any objections to followup visits?

Please list all the pets you have owned in the past five years. (If deceased, explain why and the pet's age.)

Veterinarian Information

Veterinarian Information

Is your yard fenced?

Is your yard fenced?

Fence Information

Fence Information

If you do not have a fence, will you install one?

If you do not have a fence, will you install one?

Have you ever owned a pet before?

Have you ever owned a pet before?

What kind of pet have you owned?

Are you aware that dogs / cats are active?

Are you aware that dogs / cats are active?

Have you ever sold, given away or surrendered a pet to a shelter?

Have you ever sold, given away or surrendered a pet to a shelter?

If yes, please explain why

Have you ever had to euthanize an animal?

Have you ever had to euthanize an animal?

If yes, please specify why

What arrangements will you make for your pet when you travel?

When you evacuate for a hurricane, what will you do with your pet?

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Have you or any member of your household ever been cited for animal law violations?

Have you or any member of your household ever been cited for animal law violations?

If yes, please explain

In your opinion, what would be a good reason not to keep this pet?

In your opinion, what would be a good reason not to keep this pet?

PLEASE READ: I (we) attest that the information provided on this application is true and accurate to the best of my (our) knowledge. I (we) understand that completion and submission of this application does not guarantee adoption of an animal from St. Charles. I (we) hereby permit the St. Charles Animal Shelter to contact my (our) veterinarian and landlord if applicable.

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PLEASE READ: I (we) attest that the information provided on this application is true and accurate to the best of my (our) knowledge. I (we) understand that completion and submission of this application does not guarantee adoption of an animal from St. Charles. I (we) hereby permit the St. Charles Animal Shelter to contact my (our) veterinarian and landlord if applicable.
How do you prefer we contact you?
How do you prefer we contact you?
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