Cat Adoption application

Cat Adoption Application

Western Hills Humane Society *if questions do not apply type N/A
Name Of Animal
Choose *

Kitten Cat
Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Email
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Are you over 18? *
Resident Type *

Apartment House Duplex Farm Mobile Home
Do you rent or own? *
If you rent, list your landlords name and phone number
Are animals allowed?
Size and number of animals allowed
Is there a pet deposit or additional pet rent required?
How much is the rent/deposit?
Do you currently have any pets? What breeds? *
Have your current pets been neutered or spayed? *
Are your pets up to date on their vaccines? *
If you have cats are they declawed? *
Would you declaw a cat? *
If you said yes, please explain why *
Have you ever introduced a new pet into your home? How will you facilitate the new animal meeting your current ones? *
Are you adopting this animal for you or for someone else? *
Is this animal going to be: *

a companion an office pet mouser Other
Are you aware of the life expectancy of your animal? *
Have you adopted from the Western Hills Humane Society before? *
Do you have any children in the household? What ages? *
Have the children been instructed on proper care of an animal? *
How will you handle scratching (cats) or other destructive behaviors? *
Have you ever surrendered an animal of your own into an animal shelter before? *
If you have surrendered an animal, please explain why *
Have you ever had to rehome an animal (to a new home other than a shelter)? *
If you have had to rehome an animal, please explain why *
For what reasons would you return this animal to us? *
If an outside cat, what shelter do you have for it? *
How much time a day will your cat be alone? (without human companionship) *
Where will your cat spend its time away from you? *

house garage yard kennel Other
What arrangements will you make for the care of your pets in case of an emergency or if you become unable to care for them? *
Are you aware of the medical/housing/food costs associated with owning an animal? *
Name and number of veterinarian *
What is the most common reason you have visited the vet? *
Can you afford to pay for the veterinarian costs for the animals life time? *
If you move, what will you do with your pet? *
What will you do with your animal if for any other reason you can no longer care for it *
Have you ever had an animal impounded or been issued a citation for an animal law violation? *
If yes, please explain *
Please list 2-3 references (not living with you). Please list their name, number, and who they are in reference to you. *
I would like to discuss the following with my adoption counselor:

diet/nutrition Disease/virus vaccinations costs exercising introducing pets housebreaking introducing children declawing/scratching teething/biting chewing heartworm flea/tick prevention crate training digging jumping barking/meowing obedience training Other
I certify that the information given on this application is true and accurate to the best of my knowledge. In understand that providing any false information can be cause for denial of my application or future forfeiture of the adopted pet. Leaving any question blank or not filling out this form completely can be cause for the application to be discarded or denied. By choosing to adopt, I understand that I am expected to make a considerate commitment of time and money to this animal for his/her lifetime, up to 20 years in some cases. *
Please sign
I understand that WHHS may make periodic house visits and /or telephone inquires to ensure the well-being of the animal I am adopting. I agree to cooperate full and thoughtfully with WHHS inquires and to allow WHHS to see my animal upon request. In understand that WHHS has the right to take possession of the animal, at its discretion, if during a visit WHHS determines that animal is not being properly cared for. *
please sign
If the animal is not already spayed or neutered there is an additional $75.00 spay/neuter deposit that is refundable once we receive notice that the spay or neuter procedure is done by the date indicated on your health exam and spay/neuter contract. *
please sign
“I understand the terms and conditions of this adoption and acceptable responsibility for its known and unknown health issues.” *
please sign
I, the undersigned, hereby release the Western Hills Humane Society from any and all liabilities pertaining to the adoption of the above-mentioned animal. *
please sign
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Cat Adoption Application