The Chicken Rescue - Adoption Application
Name *
Your answer
Address (street) *
Your answer
Address (city and state) *
Your answer
Phone number *
Your answer
Email address *
Your answer
How many chickens are you looking to adopt and what gender? *
Your answer
Do you have a coop and run? *
How soon will you be ready to adopt? *
Your answer
Are you at least 18 years of age? *
Do you own or rent your current home? *
Does your neighborhood have a Home Owners Association? *
Have you ever adopted from The Chicken Rescue? *
Have you adopted a rescued animal in the past? *
Do you currently have chickens? *
Have you had chickens in the past? *
List other animals currently in your care *
Your answer
Name and address of your veterinarian *
Your answer
Veterinarian's phone number *
Your answer
I understand that a representative from The Chicken Rescue may visit my home and that my application may be accepted or denied at their discretion. I also understand that the application process may be cancelled at any time at the discretion of any representative of The Chicken Rescue. *
I affirm that the above information is accruate. *
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