EBCP Adoption Application

Adoption Application
Please complete all questions to the best of your ability. We want to ensure the best matches for our animals as well as for your family. Failing to answer questions may disqualify your application.

To adopt an animal you:
- Must show current identification with present address.
- Must be at least 21 years of age.
* We take the adoption review process very seriously. We understand this is a long form to fill out at one time. At any point, you can save your form progress and come back later, by scrolling to the end and selecting SAVE, next to the SUBMIT button.

You will get a special link sent to the email you entered in the form, or you can select the Get shareable link button, once you select SAVE.

Do not close the browser window until the form is complete and ready to submit, or you have selected SAVE, at the bottom, and have received your special link.
Contact Info
Main Applicant Name:*

PrefixFirst NameMiddle NameLast Name
DOB:*

MonthDayYear
Age:*
Address:*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Home Phone:*
Cell Phone:*
Work Phone:
Email:*
example@example.com

Co-applicant Info (Spouse or significant other)
Co-applicant Contact Info
Co-applicant Name:

PrefixFirst NameMiddle NameLast Name
Co-applicant Relationship:

ParentRelativeSpouseFriendOther
Co-applicant Phone:

Main Applicant Cont.
Best way to reach you:*

HomeCellWorkTextEmailOther:
Time frame for adoption:*

ImmediatelyA few daysOther
Work status:*

Employed full-timeEmployed part-timeSelf-employedRetiredDependent on guardian or spouseSSI/DisabilityStudentUnemployedOther
Are you or your spouse active in the military?*

YesNo
Is there any chance of deployment or relocation?*

YesNo
Reason(s) why you want a cat?*

Companion for meFamily petFor an adult member of my householdFor a child in my householdGift or surprise for someone not in my householdPlaymate for current catPlaymate for other animalOther:
Have you ever been personally responsible for a pet before?*

YesNo
I’m interested in:*

CatKitten over 6 monthsKitten under 6 months
Animal Name (optional):
Home Life:
Your current residence:*

ApartmentHouseMobile HomeOther
How long have you lived there?*

Less than 1 year1-3 years3-6 years6+ years
How many times have you moved in the past 5 years?*
Do you own or rent your home?*

OwnRentOther
If you rent, we must confirm that you are allowed to have pets.
Owner, landlord, or leaseholder name:*

First NameLast Name
Owner, landlord, or leaseholder phone:*
Is there a fee to have a pet?

YesNoI don’t know
Name(s) and age(s) of household members (besides yourself):*
How would you describe your household?*

BusyQuietOther
Is any member of your household allergic to cats?*

YesNoI don't know
Do you or any member of your household smoke?*

YesNo
Cats are extremely sensitive to second-hand smoke, some essential oils, incense, perfume, household cleaning products, and other substances that may be in their environment. Please consult your veterinarian before using or continuing to use potentially harmful products in your home.
Current and Past Pets:

	Name	Type of animal	Breed	Age	Time in your care	If not in your care, when did you rehome if not deceased	Alive/Deceased	If deceased how long ago	Spayed/Neutered
1
2
3
4
5
6
7
8
9
10

Are your pets up to date on their vaccinations?*

YesNoI don't have pets currently
When were your cats last tested for the Feline Leukemia Virus?*

Within the yearWithin the past few years3+ yearsNeverOther
Are any of your cats declawed?*

YesNo
If yes, why?
Have you ever lost a pet due to an accident or illness?*

YesNo
If yes, please describe what happened:
Do your cats go outside?*

YesNo
If yes, please describe
If Your Application is Approved:
What will you feed your cat? Please provide types (wet/dry/raw) and brands if you know.*
How often will you feed her/him?*

Once a dayTwice a dayAs often as recommendedAnytime they ask
How often will you change her/his water?*

DailyOther
Where will the cat spend its time?*
Where will s/he sleep?*
What places will be off limits?*
Are you financially able and willing to provide annual checkups, vaccinations, and necessary medical care?*

YesNoI don't know
How much do you think you will spend on supplies and vet care each year?*

Less than $100Less than $1,000More than $1,000Other
Do you have a way to cover vet expenses in an emergency situation?*

YesNo
If no, please explain:
How often do you anticipate taking your cat to the vet? Check all that apply.*

Yearly or as recommendedWhen necessaryIn the event of an emergencyI don't plan to go to the vetOther
Will you let her/him outside?*

YesNoIt depends
If it depends, please explain):
How do you feel about declawing?*
Have you ever lost (could not find) a pet?*

YesNo
If yes, what did you do?
In the event that this cat gets lost, what steps would you take to find her/him?*
We understand unexpected circumstances may arise. Which of the following, if any, would cause you to give up your cat?*

AllergiesAllergies: life-threatening onlyMarriage or divorceNew baby or relationshipPregnancyMovingChild lost interestDidn’t “connect” with catDon't have enough timeIllness or death in familyLitter box misuse/aversionAggressive behaviorDestructive behaviorScratching furnitureConflict with other petsCat's healthToo expensiveToo much responsibilityCat got too bigExcessive sheddingCat doesn’t like to be heldNone of the above Other:
Have you ever given up or returned a pet for any reason?*

YesNo
If yes, please explain the reason:
How long are you willing to allow the new cat to adjust?*

1-7 daysA few weeksA few monthsA few yearsIndefinitely
How will you introduce the new cat to current pets?
Do you have a room in your home where the cat can be kept isolated from current pets until it acclimates to your family and home?*

YesNo
If yes, please describe the location(s):
Many people do not make formal plans for their pets in case of death or long-term incapacitation. They may expect a family member to assume responsibility for their pets in such a situation. This results in many animals ending up at shelters and losing their lives.
Please describe any provisions you have made for your pets in the event of an emergency or change in your ability to care for them:*
Have you or anyone in your household ever been convicted of animal abuse or neglect, or are any such charges currently pending?*

YesNo
Do you have any adoption applications pending with other groups?*

YesNo
Are you aware of our adoption fee and procedures?*

YesNo
Questions, concerns, or additional comments:
Two References:

Please provide two personal references who are not part of your household.
First Reference Name:*

First NameLast Name
First Reference Relationship:

ParentRelativeSpouseFriendOther
First Reference Phone:*
Second Reference Name:*

First NameLast Name
Second Reference Relationship:*

ParentRelativeSpouseFriendOther
Second Reference Phone:*
Veterinarian Info:
Veterinarian Clinic/Hospital:
Veterinarian Name:
City:
Phone:
How many years have you used this veterinarian?

Less than 1 year1 to 3 years3 to 6 years6+ years
By signing this form, I acknowledge that all information on this form is true and correct. I understand that any misrepresentation of fact may result in The Euclid Beach Cat Project (“EBCP”) refusing adoption privileges to me. If my request for adoption is approved and later EBCP discovers the above information is not true, whole or correct, EBCP reserves the right to remove the adopted cat(s) from my home.
Your Name:*

First NameLast Name
Your Signature:*

Clear
Co-applicant Name:

First NameLast Name
Co-applicant Signature:

Clear
Should be Empty:

Adoption Application

To adopt an animal you:

Contact Info

Co-applicant Contact Info

Home Life:

Current and Past Pets:

If Your Application is Approved:

Two References:

Veterinarian Info: