Adoption Application

Date(*)
Invalid Input

Animal Type(*)
Invalid Input

Animal ID No.
Invalid Input

Last Name(*)
Invalid Input

First Name(*)
Invalid Input

Address(*)
Invalid Input

City(*)
Invalid Input

State(*)
Invalid Input

Zip Code
Invalid Input

Email Address
Invalid Input

Home Phone Number(*)
Invalid Input

Cell Phone Number
Invalid Input

I live in(*)
Invalid Input

Number Of Adults Living in This Household(*)
Invalid Input

Number of Children in Household
Invalid Input

Children Age Range
Invalid Input

If you are not familiar with pet responsibility laws in your area, please visit wcasrock.org
Invalid Input

Have you ever brought an animal into a shelter and if so why
Invalid Input

How Many Cats In Home
Invalid Input

How Many Dogs In Home(*)
Invalid Input

Enter name and description of each animal above
Invalid Input

Why are you interested in adopting this animal (one word)
Invalid Input

How often will this pet be outside
Invalid Input

Are you familiar with the needs of this specific Breed(*)
Invalid Input

What is the name of your veterinarian or veterinary clinic or would you like a referral
Invalid Input

How Did You Hear About Us(*)
Invalid Input

We will explain the medical and behavior on this pet. Check additional topics you would like information on
Invalid Input

By signing below, I certify the information I have given is true, I am at least 18 years old, and that I understand any misrepresentation of facts may result in losing my privilege of adopting a pet through Winnebago County Animal Services. I also understand that Winnebago County Animal Services has the right to deny my request to adopt an animal, and I authorize investigation of all statements in this application
Digital Signature(*)
Invalid Input

OFFICE USE ONLY Date:________________ Staff Member:______________________ ___Approved ___Denied Reason Denied:________________________ ________________________ Verifiable Identification:____________ Animal ID Number: A____________ Comments:___________________________________________________________________________________________________
After your application has been reviewed by our staff, it will either be approved or denied in conjunction with our approval guidelines. A representative will contact you to let you know if you are approved, denied, or if we need more information. Thank You.
(*)
Invalid Input

ID Your Cat or Dog!

Use a rabies tag, microchip, or an ID tag with your name and current phone number.

Sign up for Email Alerts

Want to adopt a particular breed of dog or cat? Click to contact us!

Winnebago County Animal Services
4517 North Main Street
Rockford, IL 61103
P: 815-319-4100
F: 815-319-4101

Shelter Hours:
Monday: 11:00 AM - 7:00 PM
Tuesday-Friday: 11:00 AM - 5:00 PM
Saturday: 11:00 AM – 4:00 PM
Sunday: CLOSED
*Please note, all adoptions end 30 minutes prior to closing.

facebook youtube twitter instagram

Copyright  © Winnebago County Animal Services. All Rights Reserved.
Developed by: KMK Media Group.

Sitemap

siterips javsector.net