Cat Adoption Application

Name of Applicant

First Name

Last Name

Age of Applicant

Name of Co-Applicant

First Name

Last Name

Email Address

Cell Number

Alternative Phone Number

Employment

Home Address

Street Address

City

State / Province

ZIP / Postal Code

What type of cat are you interested in adopting? Check all that apply.

Kitten Adult Cat Senior Cat Special Needs Cat

Are you interested in adopting a specific cat?

Yes No

Which cat(s)/kitten(s) are you interested in adopting?

Describe the type of personality and/or appearance you would like your cat to have:

If the cat(s) you are interested in are no longer available for adoption, would you like us to continue to process your application for pre-approval in case another cat interests you?

Yes No

Who is this pet for?

Myself My Family A Gift for Someone Else

Are all members of the household aware of the adoption and in agreement?

Yes No

Have you applied to adopt from us previously?

Yes No

Have you adopted from us previously?

Yes No

Are you looking to adopt now, or in the future?

Describe your home

House Apartment Condo Other

Do you own or rent your home?

Own Rent

If you rent or live in a family member's home, please provide their contact information here:

Who else lives in the home or visits regularly? Please list names and ages for individuals under 18 years of age.

Is your home busy or quiet?

Busy Quiet A mix of both

Are any members of the household allergic to pets (e.g. dogs, cats etc.)?

Yes No

If you had to move, are you willing to find housing that accepts pets?

Yes No

Do you have any pets currently?

Yes No

Have you had any pets of your own in the past 10 years?

Yes No

Have you ever had a pet euthanized?

Yes No

If yes, please explain the circumstances:

Have your current or past cats been mostly indoor with some time spent outdoors? How often did they go out? Please explain:

Do you plan to let your cat out for outdoor time? If so please explain.

Did you declaw any of your past or current cats?

Yes No

Do you plan on declawing your adopted cat?

Yes No

Are you willing/able to take your pets to yearly check-ups?

Yes No

If your pet becomes ill, are you able to afford a veterinary bill?

Yes No

How many hours per day would the cat be alone?

How would you deal with behavioral issues such as excessive meowing, destructive behavior, inappropriate urination etc.?

Does your home have space (i.e. a spare bedroom, office, or bathroom) to separate new pets from current pets during the acclimation and introduction period?

Yes No

Are you willing to give your cat/kitten time to adjust to its new environment? (Note: this could take anywhere from several days to several months)

Yes No

If you have to leave town, urgently or planned, where would your cat stay or who would take care of it?

If you were no longer able to care for your pet, or had to move, what would happen to your pet?

Have you ever had to re-home a pet or surrender it to an animal shelter, animal control etc.?

Yes No

If you answered "Yes" to the above question, please explain the circumstances:

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?

Yes No

If you answered "Yes" please provide a detailed description:

Are you willing and able to care for your cat for the full duration of its life (15-20+ years)?

Yes No

Vet Clinic

Vet Clinic Phone

Last name that the pet(s) are listed under (if applicable):

Previous Vet Clinic

Previous Vet Clinic Phone

Reference 1

First Name

Last Name

Reference 1 Phone

Relationship to Reference 1

Reference 2

First Name

Last Name

Reference 2 Phone

Relationship to Reference 2

I certify that I am at least 21 years of age

Yes No

The information I have provided on this application is true. I also recognize that any misrepresentation or omissions may result in the loss of privilege to adopt from XYZ Animal Center.

Yes No

I understand that XYZ Animal Center has the right to deny any application for any reason

Yes No

I understand that XYZ Animal Center is not able to guarantee the health or temperament of any cat, as many cats come in with unknown histories. There are traits that could change upon adoption and I take responsibility to care for and address these issues if they do arise

Yes No

I understand that anything could happen in life, and if I find that I am no longer able to care for my adopted cat, I agree to contact XYZ Animal Center by phone and/or email to discuss return or need for help with the adopted animal

Yes No

I understand that I am to immediately contact XYZ Animal Center in the event that my adopted cat is lost/missing

Yes No

I attest that the cat I am adopting is for me, in my home, and NOT a gift for anyone

Yes No

I understand that I am responsible for paying for all follow-up vaccines, wellness visits & medical procedures my pet will require in the future.

Yes No

If I am adopting a kitten that is too young to be fixed (foster-to-adopt), I understand that I am to keep it separate from my other cats until it is fixed & FeLV tested.

Yes No

Additional Comments

Applicant Name

First Name

Last Name

Signature

Sign here

Date

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Cat Adoption Application

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