Chinchilla Adoption Application Form
This form MUST be completely filled out to be considered
PERSONAL INFORMATION
I would like to be considered as an adoptive parent to a chinchilla in need of a new family.
Name (First and Last):
Your email address (required - communications will be via email):
Name of chinchilla you wish to adopt:
Address:
City: State: Zip:
Phone (including area code):
Are you 18 years of age or older? Yes No
How many adults live in your household? 1 2 3 4 over 4
How many children live in your household? 0 1 2 3 4 over 4
If you have children in your household, what are their ages? (select all that apply):
Newborn - 2 years 3 - 5 years 6 - 8 years
9 - 11 years 12 - 14 years Over 14 years
Have you ever surrendered a pet to a shelter? Yes No If yes, please explain:
Have you ever had a chinchilla before? Yes No
Maintaining a healthy, happy chinchilla can cost $20-$50 per month. Are you financially able to care for a chinchilla? Yes No
A chinchilla's life span is from 10-20 years. Are you prepared to make this commitment to a new pet? Yes No
Please describe the housing (cage) you will provide for the chinchilla:
Where will you locate the chinchilla's cage? Please Select Living Room/Family Room Bedroom Child's Bedroom Dining Room Den Laundry Room Outdoors Other
Is your home air conditioned? Yes No
LIST YOUR OTHER PETS
In order to place a chinchilla in the best home possible, I need to know what it's new home environment will be like. Please tell me what other pets you have. If you have more or different species than what is listed, please include them in the box labeled "Other Pets" below.
Please Select Dog Cat Bird Hamster/Gerbil/Rat Reptile Chinchilla Guinea Pig Hedgehog 0 1 2 3 4 5 More than 5
Other Pets:
Please tell me why you want to adopt a chinchilla:
Please tell me how you found my site: Please Select Web search engine Chinchilla forum Referral by a friend Referral by a shelter Referral by a veterinarian Listing on another animal/chinchilla rescue site
By submitting an application to adopt a homeless chinchilla, you agree that the chinchilla will remain in your care. If you are unable to care for the chinchilla for the remainder of its natural lifespan, you agree that you will not give away, trade or sell the chinchilla. Any chinchilla unable to remain in your care will be returned to ForCHINate Chins, at your expense. You also agree that the chinchilla will receive proper daily care (as outlined in the care sheet that you will receive at the time of adoption), housing, attention and medical care. By submitting this application for chinchilla adoption, you understand that chinchillas are sensitive creatures, subject to stress of relocating and new environments. You also understand that the chinchilla has a life span between 10 and 20 years, and are dedicated to the lifelong care of the chinchilla.