Dalmatian Rescue of Illinois Adoption Application

Adoption Application Form

DALMATIAN RESCUE OF ILLINOIS — ADOPTION APPLICATION
Submit online, or print and mail to:
Dalmatian Rescue of Illinois, PO Box 434, DeKalb IL 60115.
• A home visit is required before adoption. • Adoption Fee $300

I. Contact Information
Last name
First name
Street Address
City
State
Zip Code
Home Phone
Work Phone
Cellphone
E-mail address


II. Home Information
How long have you lived at this address?
Do you live in a house or an apartment?	House Apartment
Do you own or rent?	Own Rent
If you rent, do you have permission to have a dog?	Yes No
Landlord's Name
Landlord's phone number
What is your occupation?
Work hours?
Please list the names of all other adults in your household:
How many children are in your household?
Please list children and their ages:
Does anyone in your home have allergies?	Yes No


III. Pets in Household
List pets currently in household:
Are your pets spayed or neutered?	Yes No
If not, why not? Please explain:
Have you owned dogs in the past? What breed? How long?
Have you ever had to give up a dog?	Yes No
If so, please explain:
Current veterinarian:
Veterinarian's phone number:
Obedience Trainer or School:
Trainer's phone number:


IV. Adoption Information
Is everyone in your household in favor of this adoption?	Yes No
Why do you want to adopt a Dalmatian?
Describe the kind of Dal that you are looking for (age, sex, color, temperament):
Is there a specific dog on our Web site that you are interested in?
Would you prefer:	Male Female No Preference
Would you prefer:	black and white liver and white No Preference
Is your yard completely fenced-in?	Yes No
If no, how will you contain the dog on your property?
If yes, will the dog be allowed to run freely in the yard?	Yes No
Please describe your yard (size, type of fence, garden, pool, etc.)
Who will feed, exercise, and train the dog?
Will anyone outside of your household have a role in caring for the dog?
Where will the dog sleep at night?
How many hours will the dog be alone each day?
Where will you keep the dog when no one is at home?
What will you do with the dog if you travel?
Please describe a typical day with your dog:
	If printing: Signature __________________________________________ Date ___________