Cat Adoption Application

Date *

Month Day Year

Full Name *

First Name Last Name

Phone Number *

Area Code Phone Number

E-mail *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Employer, phone, address *

Which cat are you interested in? *

Any specific reason you are interested in this cat?

Where did you hear about this cat?

Facebook Petfinder Friend Rescue Representative Other

Please indicate reasons for wanting to adopt this cat *

Family Pet Companion Mouser Other

Do you live in a *

House Apartment Condo Manufactured Home

Do you *

Own Rent

Does your rental agreement allow pets? *

yes I don't know conditional Owner

What are the pet restrictions, if any?

May we contact your landlord? *

yes no Owner If no, please explain:

Reason to not contact landlord:

Name of Landlord

Phone Number

Area Code Phone Number

Do you have a secure fenced yard

yes no

How long have you resided at this address?

Please check all that apply *

Busy household - children in and out a lot - visits by friends Noisy - loud TV, music, children playing, barking dogs, machinery Moderate - normal coming and going Quiet - homebodies, come home, stay home Lots of children in the neighborhood Live on a busy, fast paced street

Are there children living in the home *

yes no

Ages of children

How many people are living in your home including yourself *

Are all people living in your home aware you are adopting a cat *

yes no

If yes, does everyone approve *

yes no

Does anyone living in your home have allergies to cats *

yes no I don't know

Will your cat be: *

Indoor only Indoor/Outdoor (cat will come and go as it pleases) Outside only Mainly indoor -outside on occasion Indoor with outside time supervised Indoor only with enclosed patio/catio access

If "other", please give more info

Where will your cat sleep *

crate pet bed with owner designated room outside garage patio/porch wherever it wants

Where will your cat be when no one is home? *

free inside home crate garage Outside

Who will be responsible for the care of the cat? *

How many hours will the cat be alone in a typical 24 hour day? *

What arrangements will you make for your cat when you are traveling? *

Do you currently have other pets *

yes no

If so, names, ages, breeds: *

For current pets, check all that apply *

Up to date on vaccines Spayed/neutered Licensed in my county Currently on flea treatment

If not spayed or neutered, please provide the reason why?

Have you had any other pets in the last five years *

yes no

If yes, what happened to them or do you still have them?

Do you have any experience with the following *

Obedience training Potty training Modifying behavioral issues

We don't always know what kind of personality a rescue cat has. Are you committed to litter training and any other training your adopted cat may need? *

Please include any other experiences that you think would be beneficial when adopting one of our cats:

Most cats need time to adjust to new people and surroundings. How much time are you willing to allow for adjusting and bonding? *

Two weeks A month or longer As long as it takes

Under what circumstances would you feel it necessary to give up this cat

meowing/talkative cat moving cat damages property cat becomes ill potty accidents other

Have you ever surrendered a cat to a shelter or Humane Society or rehomed to another person and if yes please explain: *

If your pet went missing, what would you do?

Have you ever been denied adoption by a rescue, please explain:

Any animal violations, if yes please explain *

Have you or anyone in your household ever been convicted of animal neglect or abuse or other crimes. If yes please explain *

Please provide veterinarian name, phone number, and location if you have one:

A home or virtual visit by one of our rescue representatives is a requirement. Do you you consent to a home visit (During Covid19 virtual tours are acceptable) *

Please provide three references including, name, phone number,and relationship: *

IMPORTANT: All of the information I have provided is true and complete to the best of my knowledge. I agree to follow all rules and policies of Imagine Peace for Pups Rescue, Inc. I understand it is my decision on whether to adopt a cat or not. I will not hold Imagine Peace for Pups Rescue, Inc. responsible for any damage, injury or harm caused directly or indirectly to any person or property by any cat that I agree to adopt. Imagine Peace for Pups Rescue, Inc., at its sole discretion, reserves the right to refuse any applicant for any or no reason.

I agree that I will not make any claims against, sue or attach any property of Imagine Peace for Pups Rescue, Inc., its directors, officers, agents, employees, and/or volunteers for any injury or damage caused by any animal(s) adopted from Imagine Peace for Pups Rescue, Inc.

By submitting this application, I agree to all stated policies, releases, and wavers.

Do you agree to all terms stated above *

yes no I have questions that I will discuss with a rescue representative

Questions:

Signature *

CAT Adoption Application Imagine Peace for Pups Rescue, Inc.