Working Cat Application

Full Name*

First NameLast Name

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home*

Area CodePhone Number

In what type facility will the cat reside? (ex: barn, warehouse...)*

How will you provide for the cat during extreme temperatures?*

How far from the road/traffic is this facility located? *

How many working cats are you interested in adopting? *

What is the speed limit of the nearest road? *

Why do you want a barn cat? *

Barn cats must be confined in a crate inside a building for the first 3-4 weeks to ensure that they acclimate properly and do not run away. Are you prepared to allow this much time? *

Who will be responsible for the cat’s care? *

Do you agree to trap and take the cat to a vet if it becomes ill or is injured? *

Do you currently have outdoor cats? *

Have you lost cats to predators in the last 6 months? *

If you have a dog, is it permitted to run loose? *

If yes, what provisions will you make to protect the cats? *

Is there anything else you'd like us to know? *

Esignature required

*Certifications, Authorizations, Releases, and Understandings

1. I certify that all statements on this Adoption Application are made truthfully and without evasion, and further understand and agree that such statements may be investigated and if found to be false will be sufficient reason for not being allowed to adopt from Humane Society of West Michigan.

2. I understand that, with proper care, cats can live 15 years or more and I am prepared to commit myself to the long-term care and protection of any animal I adopt from Humane Society of West Michigan.

3. I understand that animal(s) I adopt from Humane Society of West Michigan may require veterinary medical or health treatment beyond that provided by Humane Society of West Michigan prior to my taking the animal(s) home. Such additional veterinary medical treatment could be costly. I acknowledge that Humane Society of West Michigan is not responsible for providing any additional veterinary treatment or the incurring cost of any additional veterinary treatment provided by veterinarians I select to provide such treatment.

4. I will not sell or give away animal(s) I adopt from Humane Society West Michigan. As long as I live in the service area of Humane Society of West Michigan, I agree to return the animal (s) to Humane Society of West Michigan in the event I cannot keep or choose not to keep the animal(s). If I move from the area, I agree to take the animal(s) to the local humane society or comparable local animal welfare organization. You may return the animal to HSWM within 30 days of adoption at no charge. During that time, you may exchange for another animal. After 30 days, you will be assessed a transfer of care fee of $20 and will not be offered an exchange.

5. I understand that the handling of unsocial/feral cats may place me in a hazardous situation and could result in injury to me or my personal property. On behalf of myself, my heirs personal representatives and assigns, I hereby release, discharge, indemnify and hold harmless Humane Society of West Michigan and its directors, employees and agents from any and all claims, causes of action and demands of any nature, whether known or unknown, arising out of or in connection with my meeting an animal for the purpose of adoption.

6. By signing below, I certify that the information I have given here is true, and I understand that Humane Society of West Michigan (HSWM) reserves the right to annul the adoption and reclaim the animal if found otherwise. I also authorize the HSWM to follow up on the care/progress/living environment of the cat(s) I have adopted.

THERE ARE RISKS INVOLVED IN ADOPTING A CAT FROM A SHELTER THE CAT YOU MAY WANT TO ADOPT HAS BEEN EXPOSED TO VIRUSES, PERHAPS BEFORE HE WAS BROUGHT HERE, BUT MOST CERTAINLY AFTER HE ARRIVED.

Humane Society of West Michigan is NOT a pet shop. We receive owned and stray animals and rescue sick, injured and abandoned ones. For a few of the owned animals, we will have veterinary records. But for most of those we receive, we will have no medical histories. In an effort to keep the cat(s) healthy while here, we maintain a clean kennel, keep fresh air circulating throughout the animal housing area, and give each cat a protective vaccination. This vaccine, called an FVRCP, attempts to protect them from Feline Viral Rhinotracheitis, Chlamydia, Calicivirus, and Panleukopenia. However, even an inoculated cat may become ill with any of these conditions since the shot does not provide immediate protection and since the cat may have been incubating the condition before being admitted to the shelter.

FURTHERMORE, CATS ARE PRONE TO A WIDE SPECTRUM OF UPPER RESPIRATORY INFECTIONS FOR WHICH THERE ARE NO INOCULATIONS. THESE INFECTIONS ARE NOT PARTICULARLY THREATENING TO A HEALTHY YOUNG ADULT CAT BUT CAN LEAD TO PNEUMONIA IN A KITTEN OR SENIOR CAT. ALTHOUGH YOUR VET CAN HELP RELIEVE THE BACTERIAL ASPECTS OF THESE INFECTIONS, YOUR VET CANNOT HELP THE CAT OVERCOME THE VIRAL ASPECTS. ONLY WHEN THE CAT’S IMMUNE SYSTEM KICKS IN WILL THE CAT FULLY RECOVER, AND RECOVERY CAN TAKE TIME. REMEMBER, THERE IS SIMPLY NO GUARANTEE THAT THE CAT YOU ADOPT MAY NOT BECOME SERIOUSLY ILL AFTER YOU HAVE TAKEN IT HOME. In their incubation stage, viruses are not detectable. Therefore, an adopted animal may look healthy on the day of adoption and begin to show symptoms of his illness a few days later – at your home.Apart from the measures we take in trying to keep shelter animals reasonably healthy, there are no other affordable precautions we can take to prevent your pet from becoming ill after adoption.

Please read and sign the following STATEMENT OF UNDERSTANDING: I understand that the animal I am interested in adopting may require medical treatment that could result in significant veterinary medical bills. I will not hold the Humane Society of West Michigan accountable for the cost of such treatment as the cat may require after adoption.By entering my name below I agree to all the above terms. I am aware that by typing my name below it is considered a signature.

Date*

MonthDayYear

Your name*

WORKING CAT APPLICATION