A Bit About You:
First name(s) *
Last name *
Age *
Street address *
City *
State *
Zip code *
Primary Phone Number *
Secondary Phone Number
Email address *
Confirm email
Driver's License Number (No dashes)
If not listing above, please bring Driver's License on day of adoption.
Have you ever been convicted of a crime against an animal? *
No Yes
If yes, please describe the convicted crime. *
Pet ownership comes with some costs — food, vet visits, emergencies, supplies — and they can add up fast. These questions help us get a general sense of your current budget and whether we can offer any guidance or support.
What type of income supports your household? (Full-time, part-time, government assistance, etc.) *
How long have you had this source of income? *
Animal You're Interested In:
What kind of pet are you looking to adopt? *
Cat
Dog
Are you interested in a specific pet?
Atlas (Dog - 281-25)
Baby Fat (Cat - 457-25)
Bitters (Cat - 359-25)
Blossom (Dog - 549-23)
Bosley (Cat - 538-25)
Bu-Cat-ti (Cat - 475-25)
Butcher (Dog - 494-25)
Candice (Cat - 424-25)
Cat-illac (Cat - 472-25)
Chlorine Please (Cat - 499-25)
Clyde Livingston (Cat - 529-25)
Crystal (Dog - 384-25)
Curly Fry (Cat - 443-25)
Derek Shepherd (Dog - 493-25)
Elya Yelnats (Cat - 530-25)
Furrari (Cat - 471-25)
General Contractor (Cat - 470-25)
God's Thumb (Cat - 525-25)
Grape Crepe (Cat - 453-25)
Hair Plug (Cat - 548-25)
Hank The Tank (Dog - 450-25)
Hector Zeroni (Cat - 518-25)
Hemera (Dog - 389-25)
Honk-Shoo (Cat - 485-25)
Jacque (Dog - 432-25)
Jaguar (Cat - 473-25)
Kimchi (Cat - 459-25)
King DeeDeeDee (Cat - 429-25)
Kirby (Cat - 431-25)
Kissing Kate Barlow (Cat - 523-25)
Kuzco's Poison (Cat - 490-25)
Lil' Bit (Dog - 546-25)
Madame Zeroni (Cat - 519-25)
Magnet (Cat - 534-25)
Male Pattern Baldness (Cat - 549-25)
Mary Lou (Cat - 531-25)
Mi Mi Mi (Cat - 498-25)
Mr. Meowgi (Cat - 407-25)
Mr. Pendanski (Cat - 527-25)
Mr. Sir (Cat - 517-25)
Mystery Brownie (Dog - 395-25)
Nyx (Dog - 129-25)
Piglet (Cat - 541-25)
Pleasant (Cat - 417-25)
Pooh (Cat - 539-25)
Potable (Cat - 500-25)
Prince of Darkness (Cat - 502-25)
Pursche (Cat - 474-25)
Pyro (Dog - 280-25)
Raspberry (Cat - 416-25)
Rattlesnake Venom (Cat - 516-25)
Roxie/ Sheba (Dog - 436-25)
Ruby (Dior) (Dog - 274-23)
Sam The Onion Man (Cat - 526-25)
Sploosh (Cat - 533-25)
Squid (Cat - 522-25)
Stanley Yelnats (Cat - 520-25)
Super Star (Cat - 441-25)
Sweet Feet (Cat - 528-25)
The Poison (Cat - 484-25)
The Poison Chosen Especially to Kill Kuzco (Cat - 489-25)
The Poison for Kuzco (Cat - 488-25)
The Safe Drinking Water Act (Cat - 491-25)
The Warden (Cat - 524-25)
Trailblazer (Cat - 551-25)
Twitch (Cat - 532-25)
Waddle Dee (Cat - 427-25)
Waddle Doo (Cat - 428-25)
Zeke (Dog - 024-22)
pH (Cat - 501-25)
Your Home Life:
Tell us a little about your home and who lives there. *
We’re just looking for a quick snapshot of the household dynamic.
For example: “Just me,” “Two adults, quiet home,” “Family of five with teenagers and a toddler,” “Live-in partner and roommate, both animal lovers.”
What type of setting do you live in? *
House
Condo/Apartment
Mobile Home
Student Housing
Farm
How long have you lived at your current residence? *
Do you rent or own? *
Rent
Own
Other
If other, please describe: *
Landlord’s name *
Landlord’s Contact Info *
If you rent, please talk to your landlord before applying to confirm whether pets are allowed — including any limits on type, size, breed, or number of pets.
Complex name, if applicable
Pet Info:
Please pay attention to this section carefully.
We use this section to understand your experience with animals and to help us complete any vet checks.
To help us do that with as little misunderstanding as possible, please list all animals in the next section like below.
For previous pets, please also include why you no longer have them (death, rehomed, etc.) and when they were last in your care.
Pet's Name; species; breed; age; routine vet
Example: Fluffy; cat; shorthair; 7; Animal Care Clinic
Are there currently dogs living at your residence? *
No Yes
Do the dogs spend the majority of their time inside or outside? *
Inside
Outside
Exclusively Outside
Are there currently cats living at your residence? *
No Yes
Do the cats live indoors or outdoors? *
Indoor
Outdoor
Indoor/outdoor
Current Pets (including all animals at the residence and all you are responsible for):
Previous Pets (any pets you've been responsible for in the last 5 years):
Vet Info
About vaccines & spay/neuter:
We typically require pets in your home to be up to date on vet care and spayed/neutered before adopting.
If that’s not the case yet, we still strongly encourage you to apply — some pets may be off-limits, or we may pause your application until it’s addressed.
We understand there are valid exceptions, so please share details if that applies. We handle all application on a case-by-case basis and we're happy to offer resources if you need help getting current.
Are you an established client at a vet? *
No Yes
Primary vet (where your current or previous pets most recent routine care would be): *
Vet's Phone Number *
Person’s name vet records are under (VERY IMPORTANT). *
Additional Vets and Phone Numbers (please list any other vets where your current or previous pet's received wellness or preventative care)
What vet clinic do you plan on using for your new pet? *
If there's any additional information about your home, pets, or veterinary care that you think would like to share, please provide it here. The more information we have on the application, the quicker it can be processed!
References:
Please choose one reference who does not live in the hosusehold.
Second reference is optional, but can speed up application process.
Reference Name *
Reference Phone Number *
Reference Name
Reference Phone Number
Matchmaking
Are you looking for a pet who does well with:
Dogs
Cats
Kids
Livestock
Frequent strangers
Doesn’t matter
What ways are you and your family most excited to spend time with your pet?
Cuddling
Adventures
Playing
Coexisting
Bonding
What size dog are you comfortable with? *
Small (<25 lbs)
Medium (25–50 lbs)
Large (50–80 lbs)
Giant (80+ lbs)
What kind of lifestyle do you want your cat to have? *
Indoors only
Indoor/Outdoor with leash walks/catios
Indoor/Outdoor with free-roaming
Working cat/barn cat
Select all the traits you're looking for in a dog!
Energetic
Calm
Snuggly
Confident
Low-key
I'm Flexible
Select all the traits you're looking for in a cat!
Lap cat
Independent
Playful
Social
Quiet
I'm Flexible
Do you plan to declaw this cat? *
Yes
No
I want an already declawed cat
I don't know yet and need info
Select all the ways you plan to confine your dog when outside *
Leash walks
Tether
Underground fence
Fenced yard
Training-based
Other
If other, please describe
The dog you adopt will spend most of it's time *
Inside
Outside
Exclusively Outside
Please tell us anything else you think would help us match you with the perfect fit!
Agreement and Signature
By signing below, I confirm that the information provided in this questionnaire is true and complete to the best of my knowledge. I understand that falsifying or omitting information may result in the denial of my application, or, if discovered after adoption, may require me to return the animal to DeKalb Humane Society without refund or exchange.
I agree to provide timely and appropriate veterinary care, including annual checkups and emergency care when needed. I confirm that I am financially able to meet the needs of this animal, including food, supplies, and medical expenses. I understand that animals must be licensed (if required by local laws) and must wear ID tags at all times.
If I am no longer able to care for the adopted animal for any reason, I agree to notify DeKalb Humane Society and return the animal to their care. I will not rehome, sell, or transfer ownership of the animal without prior written approval.
I understand that a representative from DeKalb Humane Society may visit my home before or after adoption to ensure the welfare of the animal. I agree to treat the animal with kindness, patience, and compassion and to abide by all local, state, and federal animal welfare laws.
By signing below, I acknowledge and accept these terms.
Signature (Please use your finger,stylus or mouse.)
Clear
Date *
Any final notes you'd like to add?