BCL Cat Adoption Application

Which cat(s) are you interested in?*

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

How long at this address?:*

Cell Phone Number

Area CodePhone Number

Name and Address of Employer:

E-mail*

Are you able to afford the adoption fee of $50?*

YesNo

Where did you hear of the cat you are looking to adopt?*

Are you planning on moving within the next 6 months?*

YesNo

If yes, what are your plans for your pets if you move?

Birth Date*

MonthDayYear

Do you own your own home?*

YesNo

If no, does your landlord allow cats?

Type of Dwelling:*

In what areas of the house would the new cat be allowed? (Be specific)*

Name and age of ALL occupants in household (including yourself):*

If no children, do you plan on having children or will children be visiting the household frequently?*

YesNo

What is your reason for wanting to adopt a cat?*

If other, please explain:

How many total hours will your new pet be left alone during the day?*

Are you planning on declawing your new cat or kitten?*

YesNoMaybe

Are your current cats declawed?*

YesNoN/A

Are any members of your household allergic to animals?*

YesNo

If yes, please describe:

Over the past 5 years, how many pets have you owned? (Include current pets)*

List each individually including breed, age, still living with you? (if not, why?)

Have you ever lost or given away a pet?*

YesNo

If you currently own a dog or cat, how does he/she react to new cats?

Are your present pets up-to-date on their annual vaccines?*

YesNoN/A

If no, please explain:

Are your present pets spayed or neutered?*

YesNoN/A

If no, please explain.

What plans do you have for your new pet when you are on vacation?*

Age of cat you would consider adopting: (check all that apply)*

Check all that apply. Under what conditions would you NOT KEEP your new pet?: (Check all that apply)

Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER: PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE PERMISSION TO RELEASE INFORMATION AS MANY WILL NOT GIVE US A REFERENCE W/OUT YOUR CALL, AND WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION.*

If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?*

Contact a ProfessionalUse a bookPersonal KnowledgeOther

Please explain:*

What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?*

If other, please explain:

Is your entire immediate family in agreement with the decision to bring a new pet into your home?*

YesNo

If anyone is NOT, please explain:

Are you willing to contact us to return the cat if the cat needs to be rehomed for ANY reason at ANY time?*

YesNo

Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?*

YesNo

If yes, please describe:

Where will your cat spend most of his/her time?*

If you selected outdoor, would your cat be supervised?

YesNo

Reference #1*

First and Last Name & Relationship to Self

Reference # 1 Phone Number*

Area CodePhone Number

Reference #2

First and Last Name & Relationship to Self

Reference #2 Phone Number

Area CodePhone Number

Reference #3

First and Last Name & Relationship to Self

Reference # 3 Phone Number

Area CodePhone Number

If there is anything else you think we should know, please note it here.

An adoption fee of $50 will be collected from the adopter at the time of adoption.

The Adopter agrees to keep and take good care of {petName} in the most possible safe and humane manner and shall treat as a family pet and companion.

The Adopter understands that pets require to have appropriate food, water, shelter, and medical care for the duration of its life and shall ensure they are properly taken care of and will nourish them to the best of their allowed capacity.

The Adopter understands his/her responsibility to become familiar with the local or state laws relating to licensing and animal welfare and shall abide by them.

In case of incapacity to continue to care for {petName}, it shall be the responsibility of the Adopter to inform us at Barn Cat Lady of such incapacity, and by which we shall have the right to exercise their retained Right of First Refusal in the opportunity to reclaim {petName}.

The parties understand that there are no guarantees or warranties with regard to the behavior, health or temperament of {petName}. Any damages or injuries caused by the actions of {petName} shall be borne by the Adopter.

The parties declare that they enter into this contract voluntarily, without any hesitation, or have not been induced or coerced.

In the event there is a violation of the agreement, the former owner or the shelter shall have the right to sue pertaining to violations found in the local or state laws. In addition, the former owner or the shelter shall have the right to sue for damages from the breach of this agreement.

Should any of the provisions of this Agreement be held invalid, such invalidity shall apply only to the said invalid provision and the remaining provisions shall continue to remain valid and enforceable.

No modification or alteration to any part of this contract shall be considered as having been made unless executed in writing and duly signed by the parties.

If you have read and understood the above terms, please type your name below.*

First and Last Name

Please provide up to 3 personal references

Adoption Terms

Thank you for taking the time to complete this application!.

Thank you so much for wanting to rescue a cat!!