Eccentric Kittens

YOUR NAME*

First NameLast Name

NAME OF CO-APPLICANT*

First NameLast Name

Email*

example@example.com

Social Media

NAME OF CAT/KITTEN OR WRITE "OPEN"*

AGE OF APPLICANT

Applicants must be over the age of 21 to adopt

ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

HOW LONG AT THIS ADDRESS?*

DAYTIME PHONE*

Area CodePhone Number

OWN YOUR HOME?*

RENT? PLEASE PROVIDE LANDLORD INFORMATION BELOW (if yes, you must have landlord approval)*

WHERE WILL YOUR CAT SPEND THE DAY?*

WHERE WILL YOUR CAT SPEND THE NIGHT?*

WHAT WILL YOU FEED YOUR CAT?*

ARE THERE CHILDREN IN THE FAMILY?*

YESNO

IF YES, WHAT ARE THEIR AGES?*

HAVE YOU OWNED PETS IN THE PAST 7 YEARS?*

YESNO

IF YES, WHAT HAPPENED TO THEM?*

WHAT ANIMALS DO YOU OWN NOW AND WHAT ARE THEIR AGES?*

ARE THEY SPAYED OR NEUTERED?*

YESNO

IF NO, PLEASE EXPLAIN:*

ARE ALL OF YOUR WINDOWS SCREENED?*

YESNO

DID YOU DECLAW ANY OF YOUR PAST OR CURRENT PETS?*

YESNO

DO YOU PLAN ON DECLAWING YOUR ADOPTED CAT?*

YESNO

HAVE YOU EVER HAD TO RE-HOME A PET OR SURRENDER TO AN ANIMAL SHELTER, ANIMAL CONTROL ETC?*

YESNO

IF YES, WHAT WAS THE REASON?*

IF YOU OWN OTHER CATS OR DOGS, ARE THEY CURRENT ON VACCINATIONS?*

YESNO

VETERINARIAN

Please list your current/previous/planned veterinarian(s) and thier phone numbers. We will contact them to verify your current pets are up to date on shots, fixed, and tested for retroviruses; this is a requirement for new pet adoptions. Please call their office(s) to authorize release of information to Eccentric Kittens. If you are planning to utilize another vet but are not currently a client, please note that information.

VET CLINIC

Phone Number

Area CodePhone Number

NAME OF PET(S) SEEN AT CLINIC

PREVIOUS VET CLINIC

Phone Number

Area CodePhone Number

NAME OF PET(S) SEEN AT CLINIC

PERSONAL REFERENCES

PLEASE PROVIDE 2 NON-FAMILY REFERENCES (EG. NEIGHBORS, CO-WORKERS, FRIENDS, ETC.)

REFERNCE 1 *

First NameLast Name

Phone Number*

Area CodePhone Number

REFERNCE 2*

First NameLast Name

Phone Number*

Area CodePhone Number

DOES YOUR HOME HAVE SPACE (IE. SPARE BEDROOM, OFFICE, BATHROOM) TO SEPARATE NEW PETS FROM CURRENT PETS DURING THE ACCLIMATION AND INTRODUCTION PERIOD?*

YESNO

ARE YOU WILLING TO GIVE YOUR CAT/KITTEN TIME TO ADJUST TO THIER NEW ENVIRONMENT? ( NOTE: THIS COULD TAKE ANYWHERE FROM SEVERAL DAYS TO SEVERAL MONTHS)*

YESNO

IF YOU HAD TO LEAVE TOWN, URGENTLY OR PLANNED, WHERE WOULD YOUR CAT STAY OR WHO WOULD TAKE CARE OF IT?*

ARE YOU FINANCIALLY PREPARED TO PROVIDE THE NECESSARY CARE FOR YOUR PET: INCLUDING PROPER FOOD, VACCINATIONS, PARASITE CONTROL (FLEAS, TICKS, WORMS, ETC.) ADEQUATE SHELTER, AND VETERINARY CARE FOR YEARLY CHECK-UPS AND MEDICAL EMERGENCIES?*

YESNO

I understand that Eccentric Kittens has the right to deny any application for any reason*

YesNo

I UNDERSTAND THAT I AM TO IMMEDIATELY CONTACT ECCENTRIC KITTENS IN THE EVENT THAT MY ADOPTED CAT IS LOST/MISSING.*

AGREEDISAGREE

I ATTEST THAT THE CAT I AM ADOPTING IS FOR ME, IN MY HOME AND NOT A GIFT FOR ANYONE*

AGREEDISAGREE

IF I AM ADOPTING A KITTEN THAT IS TOO YOUNG FOR SPAY/NEUTER, I UNDERSTAND THAT THE DATE IS SUBJECT TO AVAILABILITY. ECCENTRIC KITTENS WILL NOTIFY ME WITH NOTICE OF SURGERY DATE AND I WILL MAKE ARRANGEMENTS TO TRANSPORT KITTEN TO/FROM THEIR APPOINTMENT. ALL KITTENS ARE STERILIZED BY 3.5 MONTHS OF AGE*

AGREEDISAGREE

I UNDERSTAND THAT ALL CATS AND KITTENS ARE UP TO DATE ON AGE-APPROPRIATE VACCINATIONS WHICH MAY OR MAY NOT INCLUDE RABIES.*

AGREEDISAGREE

I UNDERSTAND THAT ECCENTRIC KITTENS IS NOT ABLE TO GUARANTEE THE HEALTH OR TEMPERAMENT OF ANY CAT, AS MANY CATS COME IN WITH UNKNOWN HISTORIES. THERE ARE TRAITS THAT COULD CHANGE UPON ADOPTIONS AND I TAKE FULL RESPONSIBILITY TO CARE FOR AND ADDRESS THESE ISSUES IF THEY DO ARISE.*

AGREEDISAGREE

BY TYPING MY FULL NAME BELOW, I AFFIRM THAT ALL INFORMATION ABOVE IS TRUE. I REALIZE THAT THIS IS A LIFETIME COMMITMENT AND I WILL ENDEAVOR TO GIVE THIS PET A HAPPY AND HEALTHY HOME. IF THERE ARE PROBLEMS WITH THIS PET OR I MUST GIVE THEM UP I WILL CONTACT ECCENTRIC KITTENS BY PHONE OR EMAIL TO DISCUSS RETURN/OR NEED FOR HELP OF THE ADOPTED CAT.*

TYPE FULL NAME HERE

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