Alleycats & Aristocats Adoption Application

Main Applicant Name:*

PrefixFirst NameLast Name
DOB:*

MonthDayYear
Preferred pronouns
Home Address (Applications using a P.O. Box will not be processed):*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Home Phone:*
Cell Phone:*
Work Phone:
Email:*
example@example.com

Co-applicant Info (Spouse or significant other)
Co-applicant Contact Info
Co-applicant Name:

PrefixFirst NameMiddle NameLast Name
Co-applicant Relationship:

ParentRelativeSpouseFriendSignificant other/partnerRoommateOther
Co-applicant Phone:

Main Applicant Cont.
Best way to reach you:*

HomeCellWorkTextEmail
Time frame for adoption:*

ImmediatelyA few daysOther
Have you adopted from Alleycats & Aristocats before?*

YesNo
Have you ever been personally responsible for a pet before?*

YesNo
I’m interested in:*

CatKitten over 6 monthsKitten under 6 months
Name of cat(s) / kitten(s) you are Interested in:*
Number of cats / kittens you are considering to adopt*

12More than 2
Where did you see or hear about the cat you are applying for?*

PetfinderFacebook / InstagramAlleycats & Aristocats Free-Roam ShelterPetco WadsworthPetsmart WoosterPet Supplies Plus StreetsboroPetco Middleburg HtsPetco WoosterFriend/Family memberAdopt A PetOther
Are you looking for a barn cat?*

YesNo
Work status:*

Employed full-timeEmployed part-timeSelf-employedRetiredDependent on guardian or spouseSSI/DisabilityStudentUnemployedOther
Your current residence:*

ApartmentHouseMobile HomeCollege dormOther
How long have you lived there?*

Less than 1 year1-3 years3-6 years6+ years
How many times have you moved in the past 5 years?*
Do you own or rent your home?*

OwnRentOther
If you rent, we must confirm that you are allowed to have pets.
Owner, landlord, or leaseholder name:

First NameLast Name
Owner, landlord, or leaseholder phone:
Is there a fee to have a pet?

YesNoI don’t know
Name(s) and age(s) of household members (besides yourself):*
How would you describe your household?*

BusyQuietOther
Is any member of your household allergic to cats?*

YesNoI don't know
Current and Past Pets:

	Name	Type of animal	Age	Time in your care	Alive/Deceased	Spayed/Neutered	Currently living with you
1
2
3
4
5
6

Are your pets up to date on their vaccinations?*

YesNoN/A
Are any of your cats declawed?*

YesNoN/A
If yes, why?*
Have you ever lost a pet due to an accident or illness?*

YesNoN/A
If yes, please describe what happened:
Do your cats go outside?*

YesNoN/A
If Your Application is Approved:
What will you feed your cat?*
How often will you feed her/him?*

Once a dayTwice a dayAs often as recommendedAnytime they ask
How often will you change her/his water?*

DailyOther
On average, how many hours per day would the new cat be left alone? *
Where will the cat spend its time? Where will it sleep?*
Where will s/he sleep?*
What places will be off limits?*
Are you financially able and willing to provide annual checkups, vaccinations, and necessary medical care?*

YesNoI don't know
How much do you think you will spend on food, litter and vet care each YEAR?*
Do you have a way to cover vet expenses in an emergency situation?*

YesNo
If yes please explain:*
How often do you anticipate taking your cat to the vet? Check all that apply.*

Yearly or as recommendedWhen necessaryIn the event of an emergencyOther
Will you let her/him outside?*

YesNoIt depends
If it depends, please explain:
How do you feel about declawing?*
Have you ever lost (could not find) a pet?

YesNo
If yes, what did you do?
In the event that this cat gets lost, what steps would you take to find her/him?*
We understand unexpected circumstances may arise. Which of the following, if any, would cause you to give up your cat? Select all that apply*

AllergiesAllergies: life-threatening onlyMarriage or divorceNew baby or relationshipPregnancyMovingChild lost interestDidn’t “connect” with catDon't have enough timeIllness or death in familyLitter box misuse/aversionAggressive behaviorScratching furnitureConflict with other petsCat's healthToo expensiveCat got too bigExcessive sheddingCat doesn’t like to be heldNone of the above Other:
Have you ever given up or returned a pet for any reason?*

YesNo
If yes, please explain the reason:
How long are you willing to allow the new cat to adjust?*
How will you introduce the new cat to current pets?
Do you have a room in your home where the cat can be kept isolated from current pets until it acclimates to your family and home?*

YesNoN/A
If yes, please describe the location(s):
Please describe any arrangements you have made for your pets in the event of an emergency or a change in your ability to care for them:*
Have you or anyone in your household ever been convicted of animal abuse or neglect, or are any such charges currently pending?*

YesNo
Questions, concerns, or additional comments:
Two References:

Please provide two personal references who are not part of your household. At least one reference must not be a family member.
First Reference Name:*

First NameLast Name
First Reference Relationship:*

ParentRelativeSpouseFriendOther
First Reference Phone:*
Second Reference Name (Non- Family Member):*

First NameLast Name
Second Reference Relationship:*

FriendCo-WorkerOther
Second Reference Phone:*
Veterinarian Info:
Veterinarian Clinic/Hospital - Type N/A if applicable :*
Veterinarian Name - Type N/A if applicable:*
City:
Phone:
How many years have you used this veterinarian?

Less than 1 year1 to 3 years3 to 6 years6+ years
Veterinarian Records Release Authorization*

By submitting this application, I consent to the release of my past and current pet’s veterinary records to Alleycats & Aristocats for the purpose of evaluating my cat adoption application. I authorize my veterinarian to share all relevant health and medical history information regarding my pets, including vaccinations, treatments, surgeries, and any other pertinent details.N/A - (for applicants without current pets). Please Note, If you have current pets and do not release records, we will be unable to process your application.
By signing this form, I acknowledge that all information on this form is true and correct. I understand that any misrepresentation of fact may result in denial of adoption privileges. If my request for adoption is approved and later Alleycats & Aristocats discovers the above information is not true, Alleycats & Aristocats reserves the right to remove the adopted cat(s) from my home.
Your Name:*

First NameLast Name
Your Signature:*

Clear
Co-applicant Name:

First NameLast Name
Co-applicant Signature:

Clear
STAFF ONLY
Should be Empty:

Co-applicant Contact Info

Current and Past Pets:

If Your Application is Approved:

Two References:

Veterinarian Info: