ALIVE Rescue   Adoptable Animals:  Dogs and puppies (21)  Cats and kittens (2)  Horses & Other Farm Animals (1)  All Adoptables (24) Home  ||  About ALIVE Rescue  ||  Adoptable Animals  ||  Adoption / Foster Application  ||  Adopted Animals  ||  Success Stories  ||  At The Ranch  ||  Calendar of Events  ||  Donations  ||  FREE Ways to Help  ||  Shop Till Ya Drop  ||  Volunteer  ||  Get Educated  ||  Reach Out  ||  We're Green!  ||  Wish List  ||  Good Times  ||  Our Supporters  ||  Contact Us

Adoption / Foster Application   In order to qualify for ALIVE’s program all of the following steps must be met: • You must be at least 24 years of age and be able to provide ALIVE with proof of age. • If you currently rent, you must provide a landlord’s phone number and a copy of your executed lease. • All members of the family living in the home where the animal will be placed must be interviewed. • Applicant must live within 50 miles of Chicago if interested in adopting and within 10 miles of Chicago if interested in fostering. • Allow an ALIVE representative into your home for a visit to insure that your home is safe for the potential new dog or cat. • Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet. • Currently, the requested donation to adopt a dog over 4 months of age is $250.00, a dog under 4 months of age is $300.00 and a cat is $150.00.   Foster or Adopt   Interested in fostering or adopting?       If interested in adopting, what animal are you applying for?       If interested in fostering, will you be fostering dogs or cats? Also, is there a specific animal you are interested in fostering?       Applicant / Co-Applicant Information   Name       Address       City, State, Zip Code       Home Phone Number       Mobile Phone Number       E-mail Address       Date of Birth       Do you rent or own?       Type of residence (Home / Condo / Apartment / Townhouse / Mobile Home / Other)       How long have you lived at this address?       Any plans to move in the near future?       Landlord’s/Condo board’s name:       Landlord’s/Condo board’s phone:       What is your form of transportation (car, bike, public transportation, etc.)?       How were you referred to ALIVE?       Have you applied to any other rescues before? If yes, which one(s)?       Family / Household Information   Number of adults in the household and their relationships to you:       Have all the adults in the household agreed to this adoption?       Number of children in the household and their ages:       Have the children had pets before?       Do you expect your current family situation to change? If yes, please explain.       Is anyone in the household allergic to pets?       Why would you like to adopt an animal from us? (List all that apply): • Companion for self • Companion for child • Companion for another pet • Companion for another household member • Guard Dog • Hunting • Gift • To Breed • Watch Dog / Protection • Other (Please explain)       Employment Information   Employer:       Position held:       Address City, State and Zip       Work Phone Number:       How long have you been with this employer?       Work Hours:       What is your combined household income?       Are you currently receiving any government assistance? If so, please list type and amount.       Existing & Previous Pet Ownership Information   Have you had pets in the past or do you currently have pets? Please tell us about them. For each pet list the following information: 1) Name of Pet 2) Current age or age at death 3) Breed or Mix 4) Gender 5) Spayed or Neutered? 6) Current on Vaccines? 7) De-claw, tail-dock or ear crop? If yes, please explain. 8) How & why obtained? 9) How long owned (specify years or months)? 10) If you know longer have the pet, what happened?   Pet A:       Pet B:       Pet C:       Pet D:       Pet E:       Have you ever given an animal away or relinquished an animal to a shelter? If yes, what were the circumstances?       Under what circumstances would you (or have you) euthanize(d) a pet?       Veterinarian Information   Veterinarian’s Name:       Veterinarian’s Address:       City, State, Zip Code       Veterinarian’s Phone Number:       What annual vaccines will your pet receive?       When was your current pet’s last visit to a veterinarian and why?       New Pet Information   How long have you been looking for a pet?       Is this your first pet?       What is your preferred level of exercise with a dog? (List all that apply) •Couch Potato •Short Walks •Hiking/Jogging •Long Runs •Yard Exercise •Vigorous Walks •Dog Parks •Other (Please explain)       Which characteristics are most important to you? (List all that apply) •Good with all dogs •Good with some dogs •Good with cats •Good with children •Housebroken •Mellow •Energetic •Other (Please explain)       What will you feed your new pet & how often?       How much time are you prepared to allow for your new pet to adjust to your home?       Are you prepared to spend several weeks or perhaps months waiting for your new pet to adjust to their new environment and for you to adjust to this new pet?       How do you plan to introduce your new pet to other animals and / or people in the household?       Are you able to afford a bill of $500 (or more) for emergency veterinary care?       How much are you willing to spend on medical bills and maintenance for your pet per year? □ Up to $100 □ Up to $500 □ Up to $1,000 □ Up to $5,000 □ Whatever it takes       Are you committed to providing a responsible home for your pet’s entire life (15+ years)?       If you have to move, what do you plan to do with your pet(s)?       Who in the household will be the dog’s primary care giver?       When you are out of town, who will be the dog’s primary care giver?       In case of emergency, who will care for your dog?       Where will the dog be kept during the day?       Where will the dog be kept during the evening?       How many times per day do you plan to take your dog outside?       Do you normally walk your dog on leash or off leash?       How do you plan to house train your dog?       How will you discipline the dog if it misbehaves?       What would you do if the undesirable behavior continued?       Would you be willing to attend obedience classes at your own expense?       Type of fence: • Chain-link • Wood • Wrought Iron • Solid Wall • None • Other (Please explain)       Height of fence: • 2 feet • 3 feet • 4 feet • 5 feet • 6 feet • Over 6 feet • None       Type of gate: • Chain-link • Wood • Wrought Iron • Solid Wall • None • Other (Please explain)       Number of gates:       Height of gate(s): • 2 feet • 3 feet • 4 feet • 5 feet • 6 feet • Over 6 feet • None       Type of lock: • Key entry • Latch • Padlock • None • Other (Please explain)       Who, other then members of your household, has access to your yard when you are not home?       Do you have a dog door?       Do you have a swimming pool?       If you do have a swimming pool, do you know how to introduce your dog to it?       Is the swimming pool surrounded by a fence/gate?       What is the longest period of time you would leave your pet unattended outside?       Are there times when the dog will be tied up? If yes, when?       Will the dog spend any time in the garage? If yes, explain.       If you drive a pick-up truck, would you allow the dog to ride in the bed?       How many hours per day will your dog be without human companionship?       What would you do if your dog develops a problem with the following (Please be as detailed as possible and do not leave any lines blank):   Digging:       Excessive Barking:       Biting / Play Biting:       Destructive Chewing:       Shedding Excessive Hair:       Urinating / Defecating In Unacceptable Places:       Keeping You Awake At Night:       Ruining Your Favorite Article Of Clothing:       Growling at Guests:       Separation Anxiety:       Aggression:       References   Please list 3 personal non-family references below. For each list the following: • Name • Relationship • Phone number   Reference 1       Reference 2       Reference 3       Thank you so much for your interest. We look forward to receiving your application. Allow 72 hours for an adoption/foster coordinator to review your application. Please note: Applicants who do not meet the above criteria may not be contacted. Completion of this application does not guarantee adoption of an ALIVE Rescue dog or cat.   By submitting this application, I certify that the information I have given is true. I understand that ALIVE Rescue reserves the right to deny my application for any reason. I further authorize the investigation of all statements in this application.   In the Spotlight Fidget

1937 N. Winchester Avenue (Mailing Address Only), Chicago, IL  60622    E-mail: info@aliverescue.org    Fax: 773.913.8100      ALIVE Rescue © 2010 ALIVE Rescue. All rights reserved.