Adoption Form
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
How long at this address?:
*
Home Phone Number
Cell Phone Number
Name and Address of Employer:
Work Phone Number
E-mail
*
example@example.com
Are you able to afford the adoption fee of $100?
*
Yes
No
How were you referred to Little Lions Animal Rehab and Sanctuary?
*
Are you planning on moving within the next 6 months?
*
Yes
No
If yes, what are your plans for your pets if you move?
Are you 18 years of age or older?
*
Yes
No
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
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1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Do you own your own home?
*
Yes
No
If no, name and phone # of landlord:
Type of Dwelling:
*
Please Select
House
Apartment
Condo
Mobile Home
Name and age of ALL occupants in household (including yourself):
*
If no children, do you plan on having children or will children be visiting the household frequently?
*
Yes
No
What is your reason for wanting to adopt an animal?
*
Housepet
Mouse Patrol
Companion
Companion for pet
Gift
Other
If other, please explain:
How many total hours will your new pet be left alone during the day?
*
If adopting a kitten/ puppy, where would they be kept when alone?
Are you planning on declawing your new cat or kitten?
*
Yes
No
Maybe
Are your current cats declawed?
*
Yes
No
N/A
Are any members of your household allergic to animals?
*
Yes
No
If yes, please describe:
Who will have chief responsibility for the care of your new pet?
*
Over the past 5 years, how many pets have you owned? (Include current pets)
*
Please Select
0
1
2
3
4
5
6+
List each individually including breed, age, still living with you? (if not, why?)
Have you and your spouse (if applicable) ever owned a pet together?
*
Yes
No
N/A
If yes, when?
Have you ever lost or given away a pet?
*
Yes
No
If yes, when?
If you currently own a dog or cat, how does he/she react to new animals?
Are your present pets up-to-date on their annual vaccines?
*
Yes
No
N/A
If no, please explain:
Are your present pets spayed or neutered?
*
Yes
No
N/A
If no, please explain.
Were your previous pets spayed or neutered?
*
Yes
No
N/A
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?
*
What plans do you have for your new pet when you are on vacation?
*
Which animals on our website are you interested in?
*
Age of cat you would consider adopting: (check all that apply)
*
Baby
Young
Adult
Special Needs
Senior
Can/Will you provide your cat with monthly flea/tick prevention?
*
Yes
No
Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER: PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE PERMISSION TO RELEASE INFORMATION AS MANY WILL NOT GIVE US A REFERENCE W/OUT YOUR CALL, AND WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION.
*
If your animal displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?
*
Contact a Professional
Use a book
Personal Knowledge
Other
If other, please explain:
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?
*
Move box to new location
Try a different litter
Clean box more often
Have animal examined by vet
Use a cat/ dog door
Return pet
None
Other
If other, please explain:
What brand of food do you plan on feeding your new pet?
*
Is your entire immediate family in agreement with the decision to bring a new pet into your home?
*
Yes
No
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)?
*
Yes
No
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?
*
Yes
No
If yes, please describe:
Are you willing to allow Little Lions Animal Rehab and Sanctuary to do a home visit prior to adoption? May be via video chat.
*
Yes
No
Other
If yes, please list availability:
Have you ever adopted or tried to adopt a pet before? If yes, fill out info below.
*
Yes
No
Rescue Information
Name of Rescue
Contact Name
Rescue's Phone Number
Where will your pet spend most of his/her time?
*
Please Select
Indoors Only
Outdoors Only
Indoors and Outdoors
Barn Cat
Basement/Garage
Confined
Please provide 3 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved. PLEASE BE AWARE: If your references are not easily reachable or do not reply in a timely manner, it will delay your application. If multiple references do not reply, your application will be filed on HOLD. Please choose your references carefully and be sure to list the correct contact numbers.
Reference #1
*
First and Last Name & Relationship to Self
Reference # 1 Phone Number
*
Reference #2
*
First and Last Name & Relationship to Self
Reference #2 Phone Number
*
Reference #3
*
First and Last Name & Relationship to Self
Reference # 3 Phone Number
*
If there is anything else you think we should know, please note it here.
Please remember, we are volunteers and work full time outside of the rescue. It may take up to a week for us to get back to you.
Please fill out our waver as well on the adoption waver page.
If you have any questions/ concerns email us at LittleLionsRehab@gmail.com
Thank you so much for wanting to adopt a rescue cat!!!
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