CARE Cat Adoption Application

Cat Adoption Application Form

General Information

Home

Current & Past Pets

Terms & Conditions

Name of Applicant*

First NameLast Name

Age of Applicant*

Applicants must be at least 23 years old to adopt

Which cat/s are you interested in?*

Name of Co-Applicant

First NameLast Name

Email Address*

example@example.com

Cell Number*

Format: (000) 000-0000.

Alternative Phone Number

Format: (000) 000-0000.

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

YesNo

How old are the children?

OwnRentI live with a parent, guardian or family member

If you rent or live in a family member's home, please provide their contact information here:*

YesNoMaybe

YesNo

List all current household pets:

Currently haveI did have but not anymoreNo

List all previous pets that you no longer have (within last 10 years):

Rows	Name	Type of Animal	Sex (M/F)	Age	Why don't you have them any longer?
Pet 1
Pet 2
Pet 3
Pet 4

YesNo

If yes, please explain the circumstances:

Do you plan to let your cat out for outdoor time? If so please explain.*

YesNo

How many hours per day would the cat be alone?*

YesNo

If you answered "Yes" to the above question, please explain the circumstances:

YesNo

If you answered "Yes" please provide a detailed description:

YesNo

AgreeDisagree

AgreeDisagreeN/A - I don't have any cats currentlyN/A - the cat I am applying to adopt has already been desexed

I hereby authorize THE CAT HAVEN to contact my references, veterinarian(s), and landlord to verify said statements.

Applicant Name*

First NameLast Name

Date*

Date

Type of Animal

Fixed? (Y/N)

Up-to-date on vaccines? (Y/N)