Admissions Application printable pdf download

Admissions Application

To have your pet considered for the Will County Humane Society adoption program, please complete the admissions

application. Once submitted, we will contact you about next steps, which will include a meeting with our Admissions

team and your pet, looking at medical records and evaluating behavior. See reserve side of form for fee information.

Personal Information (Please Print)

Name:

Home Address:

City:

State:

Zip:

Home Phone #:

Cell Phone #:

Fax #:

E-mail Address:

Pet Information (Please Print)

Pet Name:

Cat / Dog / Other:

Sex:

Age:

Primary Breed

Secondary Breed:

Primary Color:

Secondary Color:

Has your pet bitten anyone? If so, please describe.

Is your pet good with other animals, strangers, etc. Please describe.

Where did you get the pet from? (Friend, Shelter, Specific Store, etc.)

Why are you looking to surrender your pet?

Is your pet spayed/neutered?

Is your pet current on all vaccinations/test?

Is your pet currently taking an prescription medication? If so, please detail the drug and medical reason.

Vet Information - NOTE: A complete set of vet records is required to be submitted with this form.

Name of Vet:

Address

City:

State:

Zip:

Phone #:

E-mail Address:

(See reverse side of form for more information)

Admissions Application