Cat Adoption Application - Copy (6)-converted

CAT ADOPTION APPLICATION

Driver's License will be requested when you adopt.

This questionnaire will remain with PPAL once completed.

Completion of this application does not guarantee adoption of a cat from Paved Paws Animal League, and we retain the right to refuse adoption for any reason. All areas must be filled in order to be considered for adoption.

Applicant Information

Cat Name

Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Cell Number

Please enter a valid phone number.

Home Number

Please enter a valid phone number.

Work Number

Please enter a valid phone number.

Email

example@example.com

Birth Date

Date

Place of Employment

How long have you been at your current place of employment?

Co-Applicant Name

First Name Last Name

Co-Applicant Cell Number

Please enter a valid phone number.

Co-Applicant Home Number

Please enter a valid phone number.

Co-Applicant Work Number

Please enter a valid phone number.

Co-Applicant Birth Date

Date

Co-Applicant Email

example@example.com

Home Information

Do you

Rent Own Live with Parents Live with Roommates

If you rent, please provide name and phone number of your landlord (they will be contacted):

If renting, are you aware of your landlord’s pet policy and/or pet deposit required?

Yes No

If yes, what is the require deposit or fee $

Are you prepared to the pay the landlord’s pet deposit/fee if required?

Yes No

Application Received by (volunteer)

Vet Reference CheckedYes Yes References Checked Yes No Landlord Called Date Received:

How long have you lived at this address?

Do you have any of the following?

Patio Balcony Dog/cat door Unscreened windows Unscreened doors Back Yard Front Yard

Number of children in household

Ages of children in household

Does anyone in your present household have any on-going medical conditions (including allergies) that might interfere with pet ownership?

Yes No

If yes, please explain

Animals Owned (Past and Present)

Present - Please list all pets currently residing in your home (including roommate’s pets). If all do not fit, please include on an additional sheet or in the additional comments

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots up to Date

Yes No

Inside Outside Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots up to Date

Yes No

Inside Outside Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots Up to Date

Yes No

Inside Outside Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots Up to Date

Yes No

Inside Outside Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots up to Date

Yes No

Inside Outside Both

Past - Please list all pets that are no longer in your care that have resided in your home in the last 5 years. If all do not fit, please include on an additional sheet or in the additional comments

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots up to Date

Yes No

Inside Outside Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Inside Outside Both

Name

Breed

Age

Sex

Yes No

Altered

Yes No

Time Owned

Shots up to Date

Yes No

Indoor Outdoor Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots Up to Date

Yes No

Inside Outside Both

Name

Breed

Age

Sex

Male Female

Altered

Yes No

Time Owned

Shots Up to Date

Yes No Both

Inside Outside Both

Questionnaire

Part One - Cat Information

Why are you looking to adopt a cat at this time? (check all that apply)

Yourself Your children Family Pet Gift Companion for pet at home Other

Who will be responsible for the cat's care?

In what areas of your home will your cat be allowed?

Where will your cat sleep at night?

Cat Bed Garage Bedroom Outside Anywhere (s)he wants Other

Where will you keep the litter box?

Do you plan to declaw your new cat?

Yes No Maybe

How many hours of the day will your cat be left alone?

Where will (s)he be left when alone?

Will your new cat be an indoor or outdoor pet?

Indoor Outdoor Both

If both, how much time will your new cat be outdoors?

If allowed outside, when will be cat be allowed outside

Anytime Daytime only Under supervision On balcony/patio only On a leash Only when cat is older

Part two - Personal Information

Have you re-homed any of your former pets?

Yes No

If yes, why? Who took them?

How did you go about finding them a new home?

Have you ever turned an animal into a shelter or Animal Control?

Yes No

If yes, what was the name of the shelter or Animal Control facility, what were the circumstances, when was this and do you know what became of the pet?

Have you ever been convicted of a felony?

Yes No

If yes, please explain

Have you ever been cited, fined, or charged with an offense related to animals?

Yes No

If yes, please explain

Do you or anyone in the house, smoke in the house?

Yes No

Are you prepared to care for this pet if it becomes sick?

Yes No

Will you keep your pet up to date on vaccinations?

Yes No

Are you open for a home visit from Paved Paws Animal League?

Yes No

Veterinary References

Veterinary Clinic Name

Veterinary Clinic City/State

Veterinary Clinic Phone Number

Please enter a valid phone number.

Secondary Veterinary Clinic Name (if applicable)

Secondary Veterinary Clinic City/State

Secondary Veterinary Clinic Phone Number

Please enter a valid phone number.

Personal References

Personal References are considered individuals you have known at least tow years that are NOT family members.

Unrelated Personal Reference Name

Phone Number

Please enter a valid phone number.

Unrelated Personal Reference Name

Phone Number

Please enter a valid phone number.

Unrelated Personal Reference Name

Phone Number

Please enter a valid phone number.

I certify that the information provided on this form is true and correct. Should any of it be deemed false, this application will be denied. I give permission for Paved Paws Animal League to check all information and references to consider me for adoption per their standards. Should further information be needed, it is understood that the burden of responsibility falls on me, the prospective adopter. I am also financially and physically able to care for this animal. I understand that proper food and veterinary care can be costly and I am able to meet these requirements. I agree to provide the best possible care for the cat(s), providing for its physical, medical and emotional needs. I understand that Paved Paws Animal League adopts the cat to me in good health, to the best of their knowledge, but Paved Paws Animal League cannot guarantee the health of the cat.

Paved Paws Animal League has the right to refuse any application for any reason whatsoever

Paved Paws Animal League ALWAYS will take our adopted cats back into our rescue. If you adopt and find our kitty is not the best fit for your home, please contact us immediately by calling (864) 313-4442. Please keep in mind when we adopt out a cat, we are looking to fill that spot with another cat. We need you as the adopter, to be willing to work with us as we make a place for the kitty to return to our group. We are an all-volunteer rescue and are unable to do same day returns.

Adopter's Signature

Clear

Date

Counselor's Signature

Clear

Date

Below is for PPAL Use Only

Application Received by (volunteer)

Date

Volunteer Comments

Vet Reference Checked

Yes No

References Checked

Yes No

Landlord Called

Yes No N/A

Comments