Adoption Application

I understand that the animal(s) provided for adoption has been only recently removed from the streets and received what veterinary care could be provided due to age and health. I understand that all known information about the animal(s) will be provided to me but that it is impossible to have a complete history on this particular rescue animal(s).

I unserstand that should I be approved for adoption that there is a minimum adoption fee to be made to The Havre de Grace Community Projects, Inc.'s Stray Streets TNR committee of $75/per animal, $100 for kittens to cover spay/neuter, first vaccinations and life-time microchip registration. Two animals (encouraged in the case of kittens, especially where there is no other cats in the household) $175/both, or $135 for 2 adults. Each animal our organization spays/neuters, vaccinates & cares for daily on the streets is provided for by private donations only. Stray Streets TNR volunteers independently remove as many friendly strays as possible in an attempt to reunite lost cats with their families & find abandoned ones forever homes. It is our hope that individuals that adopt our Havre de Grace strays will remember that their families still struggle for survival on the streets by providing gift(s) to help continue our efforts to control overpopulation. Each animal that is approved by our volunteers for private adoption has been fully vetted: spay/neuter, vaccinated for rabies, distemper, treated for any injuries or illnesses, combo tested for diseases, treated for fleas & dewormed, and microchipped. The cost of this veterinary care provided for animals offered by our volunteers for adoption generally range from $160-$190 or more per animal. Every animal spayed/neutered, vaccinated, treated for wounds or illness & returned to their colonies on the streets costs generally $50-$110/per animal, not including continued feedings. Currently Stray Streets TNR is providing daily care for over 200 strays living on the streets of Havre de Grace, MD.

Animal(s) considered for adoption*

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

EMERGENCY CONTACT

First NameLast Name

Phone Number

Please enter a valid phone number.

Reason for wanting to adopt:*

What expectations do you have of this/these animal(s):*

Do you live in a:*

HouseCondoApartmentMobile Home

Do you*

OwnRent

If you are renting, have you obtained permission from your landlord to have pets?

YesNo

How many people live in the household?*

Has anyone in the household been arrested or convicted of animal, spousal, child abuse/neglect or domestic violence?

Names & contact information of other persons living in this home:

	Name	Date of Birth	Phone Number	E-mail address	Relationship to applicant	Agreed to the adoption?	Will be caregiver to animal? Y or N	Allergies?
1.
2.
3.
4.

Please list all pets you have had in the past five years

	Name	Age	Sex	Spayed/Neutered	Declawed?	Indoor/outdoor	Still living with you?	If not, why?
1.
2.
3.
5.
6.
7.
8.
9.
10.

Veterinarian's Information*

Veterinarian's NameWhere do they work? Name of business

May we contact the vet & staff?*

YesNo

Please describe where the cat will stay:*

Who will care for the cat when you are out of town, or on vacation?*

How long are you willing to keep a particular animal?*

What are you interested in adopting?*

Cat(s)Kitten(s)

If the animal should require medication now or in the future are you willing to administer?*

YesNo

Are you willing to work out any behavioral issues that might arise over time if given guidance to possible causes & solutions?

YesNo

What would you consider a deal-breaker (an issue(s) that would cause you to look to rehome the animal? Please be honest - we all have limits to our patience, financial status, etc...)*

Are you willing to transport the animal for any necessary veterinary care?*

YesNo

References: (Please chose 2 people not related to you. We do contact all references so please let them know we will be contacting them.)*

	Name	Address	E-mail	Phone Number	Years Known
1.
2.

If the animal should outlive you what is the plan for the animal?*

I declare that all information that I have provided in this document is complete and true to the best of my knowledge, that neither myself nor any person either living in my household or visiting my household has a criminal record for or is under investigation for animal abuse, domestic violence or abuse. I understand and agree that should any of the information I have provided prove false, should I fail to provide agreed upon care that the animal may be removed from my home immediatly.

Signature