Adoption Application

Seniors for Seniors
Adoption Application

Adoption fee: waived for a senior (over 60 years of age) to adopt senior cat (7+ years)

Thank you for considering a senior cat for adoption through our Seniors for Seniors program. This program aims to pair senior cats over 7+ years of age in furrever homes with senior adopters (over 60 years of age).

For this program, Tender Loving Cats, Inc. will cover reasonable emergency and sick medical care for the cats lifetime at a veterinarian of our choosing. This program does not include annual wellness, bloodwork or vaccines. We would like to place each of our senior cats in the most appropriate home, and therefore request that you fill out this application. Applicants over the age of 70 please be prepared to have a co-signer for the final Adoption Agreement.

Date*

MonthDayYear

How did you hear about Tender Loving Cats, Inc.?*

Applicant Information

Name of Primary Applicant*

First NameLast Name

Primary Applicants Birth Date*

MonthDayYear

Spouse or Co-Applicant/Signer

First NameLast Name

Spouse or Co-Applicant/Signer Birth Date

MonthDayYear

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

Email*

example@example.com

Occupation

Work Phone

Area CodePhone Number

Driver's License #

Family/Household Information

Do you own or rent?*

OwnRent

If you rent, who is your landlord?*

First NameLast Name

Landlord phone #*

Area CodePhone Number

Are cats allowed?*

YesNoUnsureOther

How many rooms in your household?*

Are there screens on all your windows?*

YesNo

Do you or does anyone in your household smoke cigarettes inside the house?*

YesNo

Check all that live in your household

How many adults over 21?

Have all the adults in the household agreed to this adoption?

How many children?

Ages of children

Have the children had cats before or been raised around cats?

YesNo

Do any household family members have allergies to cats?

YesNo

If yes, please explain:

What best describes your household?

Quiet, Laid BackSometimes Quiet, Sometimes Laid BackNoisy, ActiveOther

Which cat would you like to adopt?

1st Choice*

2nd Choice

Have you already met the cat/kitten(s) you are applying to adopt?*

YesNo

If yes, what is the name of the volunteer who helped you?

Would you consider adopting a pair?*

YesNoMaybe

Why do you want a cat?*

CompanionshipFor a grandchildOther

Is the cat for*

YourselfA giftOther

If a gift, for whom

Is the cat/kitten(s) a surprise?*

YesNo

Where will your adopted cat live?*

IndoorsOutdoorsBoth

Are you willing to have a litter pan in your home?*

YesNo

Do you own a pet carrier?*

YesNo

Are you aware that the average house cat's life expectancy is 15-19 years?*

YesNo

Do you have the finances to provide daily food, litter and annual wellness exams and bloodwork?*

YesNo

Who will be the primary caretaker of your new cat?*

How many hours in a day will your cat be home alone?*

Where will the cat be left?*

Are you considering having your new cat declawed?*

YesNoUnsureOther

Are there any bad habits you will not tolerate from a cat?*

Cats need preparation training for life changes such as being around young children or babies, household renovations, etc. Are you committed to working through these changes if they occur?*

YesNo

If you have to move, what do you plan to do with your pet(s)?*

How will you care for your cat when you go away for a vacation?*

If you are not able to care and provide for your cat, who will assume this responsibility?*

First NameLast Name

Phone # of person to be responsible*

Area CodePhone Number

Have you ever given an animal away or relinquished an animal to a shelter?*

YesNo

If yes, what were the circumstances?

Is there anything additional you can tell us about yourself in relation to this adoption?

Pet Information

Please tell us about any pets that currently live in your home:*

CatsDogsCurrently do not have a pet(s)Never had a pet

If checked cats, how many?

If checked dogs, how many?

Have your pet(s) been around cats before?

YesNoOther

What is your pet's disposition and behavior towards cats?

Have your animals been spayed or neutered?

YesNo

Do you have any other pets, besides cats or dogs?

YesNo

If yes, please specify what kind and how many:

Are your animals current on all vaccinations (rabies and distemper vaccines)?

YesNo

If cats, have they been tested NEGATIVE for FeLV?

YesNo

If you own cats, are any of your cats declawed?

YesNo

Do you let your current cats outdoors?

YesNo

Do you feed any feral/stray cats?*

YesNo

Are the feral/stray cats you are feeding all spayed/neutered?*

YesNoUnsureNot Applicable

Current/Past Pets (Owned in the past 10 years)

Pet 1:

Pet type

Name

Sex

MaleFemale

Age (human years)

Spayed/Neutered

YesNo

How long have you had this pet?

Where does this pet spend most of its time?

Do you still have this pet? If not, please explain:

Pet 2:

Pet type

Name

Sex

MaleFemale

Age (human years)

Spayed/Neutered

YesNo

How long have you had this pet?

Where does this pet spend most of its time?

Do you still have this pet? If not, please explain:

Pet 3:

Pet type

Name

Sex

MaleFemale

Age (human years)

Spayed/Neutered

YesNo

How long have you had this pet?

Where does this pet spend most of its time?

Do you still have this pet? If not, please explain:

Pet 4:

Pet type

Name

Sex

MaleFemale

Age (human years)

Spayed/Neutered

YesNo

How long have you had this pet?

Where does this pet spend most of its time?

Do you still have this pet? If not, please explain:

Personal References

(Other than relatives)

Reference 1:

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Relation*

Reference 2:

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Relation*

Veterinary Reference

(List a vet who has seen your pets)

Name of Animal Hospital

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Whose name are the pets listed under at your vet?

First NameLast Name

Tender Loving Cats, Inc. is a not-for-profit organization staffed entirely by volunteers who are committed to serving the best interest of the animals in its care. We therefore reserve the right to select the home that best meets the needs of each animal up for adoption. Tender Loving Cats, Inc. reserves the right to deny any application for any reason.

Tender Loving Cats, Inc. does not sell animals.

All cats and kittens adopted from Tender Loving Cats, Inc. are spayed/neutered prior to adoption as a part of our mission to reduce the numbers of homeless cats and kittens on Long Island.

By signing, I understand that the information I have provided will be verified before I am approved to adopt. Falsification or omission of any of the requested information will result in denial of adoption. I agree to the terms of this adoption application. I further understand that the references I listed on this application will be contacted and a home check will be required if my application is approved.

Please ensure that you see a green check mark that says “successfully submitted” and receive a copy of your application to your email. If not, your application may not have been received.

Signature*

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