RVAR Adoption Application - River Valley Animal Rescue | Pet Adoption Momence, IL

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Thank You For Your Interest In Adopting A New Pet
Please Fill Out the Form Below and SUBMIT

Adoption Application

In order to be considered for adopting, you must be 21 years of age or older and have a current utility bill showing proof of your address and a driver's license or state ID for application verification purposes. In addition to these things, RVAR reserves the right to perform a home visit before and after the adoption takes place.
****Please remember any asterisked * field is required. Application will not submit unless all required fields are filled in.

* Indicates required field

Name *

First

Last

Animal You Wish To Adopt *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Home Number *

Cell/Work Phone *

What type of home do you live in? *

House Apartment Other

Do you? *

Own Rent Live with parents/roommate

Are you planning on relocating in the next 30 days *

No Yes

Where will the animal be living *

Inside Outside Other

If other where will animal live? *

If adopting dog do you have fenced yard? *

Yes No

If no fence how are you planning on exercising a dog? *

How long have you lived at this address? *

If less than a year what is your previous address? *

If you rent, will you allow us to verify animals are allowed? *

Yes No

Landlord/Management Co. - Name and Phone *

If you move in future what are your plans for your animal? *

Dogs and cats can live more than 15 years. Are you prepared to care for the animal for its entire life? *

Yes No

Will you return the animal to RVAR if you can no longer care for it? *

Yes No

Number of Adults in your household *

Children (please enter N/A if none) *

Children's ages (please enter N/A if none) *

Is everyone in household in agreement on adopting a pet? *

Yes No

If no, please explain? *

Does anyone have pet related allergies? IF so please explain. *

Have you previously applied to adopt from RVAR? *

Yes No

If yes, when did you apply? *

Is this your first companion animal? *

Yes No

IF adopting dog will you give animal heartworm Prevention *

Yes No

How much do you estimate spending yearly to feed, groom, license and vet your animal? *

If your animal becomes ill or injured, are you financially prepared to seek medical care? *

Yes No

IF needed will your pet attend obedience training classes? *

Yes No

If you are out of town how will your animal be cared for? *

It may take a month or longer for your pet to adjust to a new home. Are you willing to allow time for adjustment? *

Yes No

List any current pets or pets you have owned in the past:

Type *

Name *

WHere Kept *

Age *

Altered (Y/N) *

Gender *

Still Owned (y/n) *

If not owned, what happened? *

Type *

Name *

Where Kept *

Age *

Altered (Y/N) *

Gender *

Still owned (y/n) *

If not owned, what happened? *

Type *

Name *

Where Kept *

Age *

Altered (y/n) *

Gender *

Still Owned (Y/N) *

If not, what happened? *

Type *

Name *

Where Kept *

Age *

Altered (Y/N) *

Gender *

Still Owned (Y/N) *

If not, what happened? *

Type *

Name *

Where Kept *

Age *

Altered (y/n) *

Gender *

Still Owned (Y/N) *

If not, what happened? *

Are your current animals Up To Date on vacinations? *

Yes No

Please provide your veterinarians information:

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Date of last visit *

Will you continue to use this vet? *

Yes No

Please Provide Three References:

Reference #1 *

Phone Number *

Reference #2 *

Phone Number *

Reference #3 *

Phone Number *

Terms of Application Agreement

I certify that the information provided on this application is true and correct to the best of my knowledge. I also acknowledge that falsification of any information on this application can result in my being denied adoption of an animal. I authorize investigations of all statements contained in this application and understand veterinarians, other humane agencies, landlords, etc. may be contacted. I further understand that the adoption of an animal may be delayed until information on this application can be verified.

Please Check *

Yes, I certify my information

Name *

First

Last

Date *

Please review all * fields are required to submit. You should receive a confirmation email if your application was submitted successfully.

Submit Application

Contact Us

RVAR Shelter

3960 Vincennes Trail
Momence, IL 60954
(815) 507-5007
Email: shelter@rivervalleyanimalrescue.org

River Valley Pet Resort

12260E. 5500N. Rd.
Momence, IL 60954
(815) 472-6836

River Valley Cat Oasis

117 E Washington St.
Momence, IL 60954
(815) 507-5007
Email: shelter@rivervalleyanimalrescue.org

Hours of Operation

Shelter Hours:

Tuesday - Saturday
12pm - 4pm
Sunday & Monday- CLOSED

Resort Pick Up/Drop Off Hours:

Monday - Saturday
10am - 12pm and 4pm - 5pm
Sunday - 4pm - 5pm

Cat Oasis Hours:

Monday, Wednesday, Thursday
12:00 - 4:00 PM
All other days by Appointment Only

Make A Donation!

Gain the knowledge that
your contribution is
helping to save the
Kankakee area's abused,
abandoned and neglected
companion animals!

Copyright © River Valley Animal Rescue. All Rights Reserved.

Home
About
Adopt
Volunteer
Cat Oasis
Donate
RVAR Pet Resort
Ceasar's Palace Resale for Rescue
Contact
Events