Amber's Safe Haven Adoption Application

Amber's Safe Haven for Cats Adoption Application
Amber's Safe Haven for Cats is an all-volunteer, non-profit, cat rescue and TNR (trap/neuter or spay/return) group, dedicated to helping stray and feral cats. Amber's Safe Haven is completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive a vet health check, deworming, first vaccination and spaying/neutering.
This questionnaire is designed to help us and yourself determine if a specific cat is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Amber's Safe Haven reserves the right to deny any adoption based on answers to this questionnaire prior to adoptions! You will be contacted within 24hrs of submitting an application if approved, if you have not been contacted this means we have found the best fit for the animal you are applying for.

Adoption Fees:

$250 - kittens (8 weeks - 6 months old)

$175 - adults (7 months - 10 years old)

$125 - seniors (10 years old +)

Adoption fees are non refundable as they go towards the much needed vet care of our cats. Adoption fees are used to recoup some of the funds needed for the cat while in our care.

If you are approved to adopt the cat you are applying for you will also have to sign an adoption contract/waiver which will be sent to you via Email.
Applicant Information
Your full name:*
Name of cat(s) you are applying for:*
Your age:*
Street Address:*
City, State, Zip*
Home Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:
References

Must include 3 references. We will be contacting these references to ask some brief questions.
1st Reference phone number (only 1 family member) :
2nd Reference and phone number (only 1 family member) :
3rd Reference and phone number (only 1 family member) :
Household Information
Who will be the pet's primary caregiver?*
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Do you own or rent?*

OwnRentLive with a relative / parents
Do you live in a*

HouseApartmentCondoMobile HomeOther
If rent, provide name and phone number of landlord:
Does your landlord allow cats?

YesNo
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?

YesNo
Select your employment status*

Work full timeWork part timeRetiredStay at home parentUnemployedOther
Current/Previous Pet Information
How many of these pets are spayed/neutered?
List any pets you own or have owned in the past 30 years (age, breed, sex)
Where are these animals now?
Have you adopted from an animal rescue group or shelter before?

YesNo
If yes, what group?
Have you ever given up a pet?

YesNo
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
Basic Information
Are you aware that cats will take some time to adjust in a new environment? Will you give this cat the time and space they require to become comfortable in their new home?*
Are you able to provide this cat with any medical care it may need in the future? (Booster vaccinations, vet visits, emergency visits in case of an emergency?)*

YesNo
How many hours each day will your new pet be home alone?*
What length of time will you allow your new pet to adjust to his new home?*
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Do you intend on allowing your cat outside?*

YesNoOnly in secured catio or on leashUndecided
If having to move from your current living arrangements, what would you do with your cat? What is pet friendly options can not be found?
Reason for adopting this cat?*

Family companionGift for another personRodent controlOther
Pet insurance is a good thing to have on your new family member. Although not required to adopt we do suggest that you start your new pet on a pet insurance like Trupanion to cover any unexpected things that can occur over the lifetime of owning your cat. Please indicate if you will be insuring your pet and with which company below:
Cats adopted from Amber's Safe Haven are not permitted to be rehomed or sold without notifying the group, we require cats to come back to our care if you can no longer care for them. Do you agree to these terms?*

YesNo
If a family member was to develop allergies to the cat - how would you handle this situation?*
Do you have any questions or concerns about adopting?
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Should be Empty:

Amber's Safe Haven for Cats Adoption Application

Applicant Information

References

Household Information

Current/Previous Pet Information

Basic Information