VCAS Adoption Application

Please complete the application in full.

Once your application and all supporting documents are submitted, we will be in contact within 48 hours. If approved for adoption, we will schedule a time for you to come in to meet the animal(s) that you are interested in.

If you currently have a dog(s), and are looking to add another dog to your family, we do require a meet and greet. Exceptions to this will be reviewed on a case by case basis.

If you are interested in adopting a dog and have any children under 12 years of age living in your household, we will require a meet and greet between the children and dog(s) you are interested in adopting.

We look forward to working with you to find the animal that will best fit into your lifestyle and family.

*Required

Agreement

In completing this application, I affirm that all information and statements in this application are complete and true and made for the purposes of my applying to adopt one or more animals through VCAS.
I am 18 years of age or older.
I understand that all residents of the household must agree to adoption and all household members, children included, must meet with the animal prior to adoption approval.
I understand that all dogs residing at the home must come to the shelter for a meet and greet with the animal prior to adoption approval, unless otherwise discussed, in advance with the Director or Kennel Supervisor.
I understand that a Shelter representative may visit my home for a home inspection before my application is approved.
I agree and understand that if the animal I apply for is not spayed or neutered, it will remain property of VCAS until completed.
I agree to provide basic medical vet care for adopted animal.
I agree to provide rabies vaccinations according to my local county ordinance.
I agree to maintain heartworm and/or flea and tick prevention during every month of the year.
I understand that if approved for adoption, I will be required to carefully read the "Adoption Agreement" in full, and acknowledge that the Adoption Agreement represents a legal and binding contract between an adopter and the Vermilion County Animal Shelter.
I understand that if I am approved to adopt an animal, the Adoption Agreement must be reviewed before I can take my animal home. I further understand that I will be asked to agree to the terms of the Agreement and sign the Agreement before I can take my adopted animal home.
If there is more than one application submitted for a specific animal, the adopter that best meets the needs of the animal will be approved.
VCAS reserves the right to refuse any adoptions we consider unsatisfactory.

Do you agree to the above adoption agreement?

Yes, I agree

No, I disagree

First Name

Last Name

Current Phone Number

Current Address

Address Line 1

City

Zip Code

In the past 10 years, have you resided at any other address other than your current address?

Yes

Please list any prior addresses you have lived at in the last 10 years. Enter street address, city, state, zip and county.

Date of Birth (mm/dd/yyyy)

Driver's License or State ID number

State that issued ID

Please upload a picture of your photo ID.

Choose File

I'm interested in adopting (check all that apply)

Puppy (under 6 months)

Young Dog (6-12 months)

Adult Dog (1-7 years)

Senior Dog (over 8 years)

Kitten (under 6 months)

Young Cat (6-12 months)

Adult Cat (1-7 years)

Senior Cat (over 8 years)

Bonded pair of cats or kittens

Which size dog are you interested in adopting? (check all that apply)

Small (up to 25 lbs)

Medium (26-50 lbs)

Large (51-80 lbs)

Extra Large (over 80 lbs)

Is there a specific dog or cat you are interested in? Please list the animal's name.

Is this your first pet?

Yes

Other

You selected "other" on the question "Is this your first pet?" Please explain.

Are you currently employed?

Yes

Employment Information

Employer or Business (if self-employed)

Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Your Position

Length of Employment

Employer Contact Phone Number

Employer Contact Email Address

Residential Information

Please check one of the following

I OWN my own home and am permitted to bring an animal or animals into my dwelling

I RENT my home and am permitted to bring an animal or animals into my dwelling.

I live with a parent or relative and am permitted to bring an animal or animals into my dwelling.

If you rent or live with a parent or relative, please provide the following information: Landlords name, telephone number, street address, city, state, and zip code.

Length of time at this residence

If you rent, please upload a copy or picture of your lease or pet policy that was provided to you by your landlord. If this is not included in your application, your application will not be processed.

Choose File

Are there any other adults (18 and over) living in your household?

Yes

Please list first and last names, as well as birth dates for all adults (18 and over) living in your household.

Are there any children (under 18) living in your household?

Yes

Please list first and last names, as well as birth dates for all children (under 18) living in your household.

Companion Animals in Your Home

Do you currently have any companion animals in your home

Yes

Please provide the name of the veterinarian, phone number, street address, city, state, and zip code that you currently use or plan to use after adoption.

Companion Animal Information

Animal 1

Animal 1 - Type

Dog

Cat

Other

Animal 1 - Please specify what type of animal this is.

Animal 1 - Name

Animal 1 - Age

Animal 1 - Breed

Animal 1 - Male or Female

Male

Female

Animal 1 - Has the animal been spayed or neutered?

Yes

Animal 1 - Does the animal currently reside in your home?

Yes

The animal resided in my home within the last 5 years but is no longer with me.

Animal 1 - Is the pet up-to-date on vaccinations and registered in the county in which you reside?

Yes

Other

Animal 1 - Please explain your pet's vaccination and registration status

Animal 1 - Please upload proof of your animal's current vaccinations

Choose File

Animal 1 - Please upload a copy of your animal's current rabies certification

Choose File

Add 2nd Animal

Animal 2

Animal 2 - Type

Dog

Cat

Other

Animal 2 - Please specify what type of animal this is.

Animal 2 - Name

Animal 2 - Age

Animal 2 - Breed

Animal 2 - Male or Female

Male

Female

Animal 2 - Has the animal been spayed or neutered?

Yes

Animal 2 - Does the animal currently reside in your home?

Yes

The animal resided in my home within the last 5 years but is no longer with me.

Animal 2 - Is the pet up-to-date on vaccinations and registered in the county in which you reside?

Yes

Other

Animal 2 - Please explain your pet's vaccination and registration status

Animal 2 - Please upload proof of your animal's current vaccinations

Choose File

Animal 2 - Please upload a copy of your animal's current rabies certification

Choose File

Add 3rd Animal

Animal 3

Animal 3 - Type

Dog

Cat

Other

Animal 3 - Please specify what type of animal this is.

Animal 3 - Name

Animal 3 - Age

Animal 3 - Breed

Animal 3 - Male or Female

Male

Female

Animal 3 - Has the animal been spayed or neutered?

Yes

Animal 3 - Does the animal currently reside in your home?

Yes

The animal resided in my home within the last 5 years but is no longer with me.

Animal 3 - Is the pet up-to-date on vaccinations and registered in the county in which you reside?

Yes

Other

Animal 3 - Please explain your pet's vaccination and registration status

Animal 3 - Please upload proof of your animal's current vaccinations

Choose File

Animal 3 - Please upload a copy of your animal's current rabies certification

Choose File

Add 4th Animal

Animal 4

Animal 4 - Type

Dog

Cat

Other

Animal 4 - Please specify what type of animal this is.

Animal 4 - Name

Animal 4 - Age

Animal 4 - Breed

Animal 4 - Male or Female

Male

Female

Animal 4 - Has the animal been spayed or neutered?

Yes

Animal 4 - Does the animal currently reside in your home?

Yes

The animal resided in my home within the last 5 years but is no longer with me.

Animal 4 - Is the pet up-to-date on vaccinations and registered in the county in which you reside?

Yes

Other

Animal 4 - Please explain your pet's vaccination and registration status

Animal 4 - Please upload proof of your animal's current vaccinations

Choose File

Animal 4 - Please upload a copy of your animal's current rabies certification

Choose File

Additional Information

Where will your adopted pet be kept while you are away from your home?

How long will your adopted pet be alone during the day?

How long will your adopted pet be kept outside?

Where will your adopted pet be kept at night?

Which of the following best describes your reasons for wanting to adopt? Please check all that apply.

Companion

Jogging Buddy

Couch Warmer / Couch Potato

Adventure Buddy (hiking, swimming, boating, etc.)

Protection

Travel Buddy

Hunting

Working (sports, service, etc.) or Emotional Support Animal

How do you plan to keep your animal on your property? Please check all that apply.

In the house only

Garage

Outdoor Kennel/Run

Patio

Fenced Yard

Chained or Tethered

Which of the following would cause you to give up this animal? Please check any and all that apply.

Job Change

Change in Family Status/Divorce/New Significant Other

Moving

New Baby

Unexpected Veterinary Care

Other

You selected "other." Please explain.

Have you ever relinquished a pet to a shelter, veterinary clinic, or given a pet away? This is not a deciding factor on your application - we understand that life happens.

Yes

Other

You answered "yes" or "other" to the previous question. Please explain the circumstances that caused you to relinquish the pet.

Have you ever owned an animal that has been confiscated by animal control for violations of state or local regulations or due to a breach in an adoption contract?

Yes

Other

You answered "yes" or "other" to the previous question. Please explain the circumstances the situation that occurred.

Have you ever been subjected to legal action for cruelty or neglect of animals?

Yes

Other

You selected "other." Please explain.

Agreement and Document Upload.

I hereby release to the Vermilion County Animal Shelter all veterinary records of any and all animals I own and have owned. I certify that the above information is true and correct to the best of my knowledge. I also acknowledge falsifying any of the above application will result in my being denied adoption of an animal or if any animal has been adopted to me, the return of the animal to the Vermilion County Animal Shelter. I have completed and reviewed this Application in its entirety, and I agree that all statements contained herein are made by me, and are truthful and binding. I make this statement under penalty of perjury under the laws of the state(s) of Illinois.