Second Chance Cat Adoption Form

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

How long at this address?:*

Home Phone Number*

Area CodePhone Number

Cell Phone Number

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Name and Address of Employer:

E-mail*

Full names of all adults living in the home

Do you have children? If so, how many and what ages are they?*

Are you 18 years of age or older?*

YesNo

Birth Date*

MonthDayYear

Do you own, rent, live with parents?*

OwnRentLive with parents

Type of Dwelling:*

If you rent, does your landlord allow pet?

YesNo

Name of landlord and phone number:

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

Does anyone in your household suffer from allergies or asthma?

YesNo

Which cat(s) on our website are you interested in?*

Are you prepared to commit to a pet for 15 - 20 years (average life span)?*

YesNo

Will you allow a representative from SCPN to visit your home and contact your current vet prior to adoption to determine suitability?*

YesNo

Name of Veterinarian that will be looking after your cat?*

Who will be responsible for the care and training of this cat?*

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:

Do you have the financial resources to cover the ongoing care of this cat? (Food, annual vet check ups, vaccines, licensing, etc)*

YesNoUnsure

Have you ever adopted or tried to adopt a pet before? If yes, fill out info below.*

YesNo

How many pets have you had in the last 5 years?*

Were they spayed and/or neutered?*

YesNo

How many pets do you currently have?*

Are they spayed and/or neutered?*

YesNo

Are they up to date on their vaccines?*

YesNoUnsure

Are you aware that all Second Chance cats must be spayed and/or neutered at the appropriate age?*

YesNo

Are you aware that Second Chance has a policy against declawing animals? Please read the above poster*

YesNo

Will your cat be inside, outside, or both?*

Indoor onlyOutdoor onlyBoth

Are you aware of all local animal bylaws and licensing requirements?*

YesNo

Are you aware that Second Chance Pet Network offers microchip services for your pets?*

YesNo

Have you disposed of or given away any pets in the last 10 years? If yes, please explain below*

YesNo

If yes, please explain

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

Please be aware that a pet is for life and a part of the family. A pet can live to be 20 years old or more and you will be responsible for the life of that pet.

Please take the following into consideration:

1. If you move, your pet moves with you!

2. If you acquire a new partner, ensure that partner likes pets!

3. Allergies can be dealt with a lot of the time! It's possible you could be allergic to more than dander, get checked out by your doctor! Keep one room pet free (like your bedroom). Make sure all pet products are machine wash friendly, vaccuum regularly (including furniture), bathe/brush your pet!

4. Your pet is like a child, it will be attention, love, patience, training and commitment.

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