AP PRE-ADOPTION APPLICATION

Name:*

Date: *

Name/Type of cat(s)/kitten(s) you are interested in:*

Home Phone:*

Address:*

City, State, Zip Code:*

Work Phone:

E-mail:*

example@example.com

How long have you lived at this address?

Do you own or rent?

If renting, when does your lease expire?

If renting, have you confirmed that animals are permitted in your building? (Y/N)

Does your home have a terrace? (Y/N) *

Does your home have a back yard? (Y/N) *

Does your home have screens on the windows? (Y/N) *

Please provide name, relationship and ages of everyone currently living in your household:

	Name/Relationship to you	Age	Name/Relationship to you	Age

Does anyone in your home have allergies to animals? (Y/N)

Please specify if yes

Are you adopting the animal for yourself or for someone else?*

What is your age?*

Do you know that cats can live fifteen or twenty years? (Y/N)*

Are you ready to make such a long-term commitment? (Y/N)*

Under what circumstances would you choose to give up your cat?

Please provide the following information for each animal companion CURRENTLY living in your household:

	Animal Name	Type/Breed	Age & Sex	Spayed/Neutered?

Have you ever had a companion animal before (not including current animals listed above)? If yes, please provide any relevant information about the animal(s), including why they are no longer with you:*

Have you ever had to give up or re-home an animal? If yes, what were the circumstances?*

Please provide your Veterinarian’s Name & Practice (if none, say NA):

Veterinarian’s address:

Phone:

Please supply TWO personal references:

Reference 1 Name:*

Relationship:*

Email:*

example@example.com

Phone:*

Reference 2 Name:*

Relationship:*

Email:*

example@example.com

Phone:*

What is your current occupation?*

Who is your current employer?*

How long have you worked there? (yrs/mons)

Address:

Phone:*

Please supply ONE business reference: (write NA if doesnt apply)

Name:

Relationship:

Email:

example@example.com

Phone:

Previous employer:

How long did you work there?

Previous job title:

Does your current job require extensive travel? (Y/N)

How many weeks/months per year do you travel for work and recreation?

What arrangements will you make for the care of your companion animal when you travel on business or vacation?*

Would you prefer to adopt a declawed cat? (Y/N)

Would you prefer to adopt a cat who can catch mice? (Y/N)

How did you find out about The Animal Project’s adoptions?

By signing below, I certify that the above information is true, and I authorize The Animal Project with permission to contact references and verify the information that I have provided herein. I understand that the completion of this pre-adoption application is only the first step in The Animal Project’s companion animal adoption process, and does not guarantee any adoption of any animal to me by The Animal Project. The Animal Project reserves the right to make an in-home screening visit and to deliver any adopted animal, in order to further assess the likelihood that I will provide them with a hazard-free home.*

Date

PRE-ADOPTION APPLICATION

HOUSEHOLD INFORMATION

CURRENT ANIMALS

REFERENCES