Adoption Application Form
Name of cat(s) you are applying for:
Applicant Details
Name
*
First Name
Last Name
Co-applicant name (Required if spouse/parter/etc.)
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Birthdate
*
-
Month
-
Day
Year
Applicants must be atleast 21 years old
Occupation(s)
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list the names of all people and their ages that reside in the home
*
Is anyone in the home allergic to cats?
*
Yes
No
Are you expecting any major life changes in the next few months (starting a family, adopting a dog, moving, traveling long term, etc.) If yes, please explain:
Do you rent or own a home?
*
Rent
Own
If you rent please provide landlord name & phone number:
If you were to move, what would you do with your pets?
*
Are you prepared to accept the habits and lifestyles of cats, such as jumping on furniture, scratching, etc?
*
Why are you interested in adopting this cat(s)?
*
companion for myself/my family
companion for another pet
a mouser
Other
Are you planning on declawing?
*
yes
no
unsure
Where would the animal live?
outdoors
indoors
indoor/outdoor
restricted areas indoors
Do you have screens on your windows?
yes
no
Have you had pets before?
yes
no
If yes, what kind of pets have you had?
Where are those pets now?
Have you ever surrendered, re-homed, gave away, sold or abandoned a pet?
yes
no
If you answered yes, please explain the situation
*
Please list all of the animals currently living in your household and where you got them (if a rescue, please list what rescue you got them from): Include pet name, age, breed, sex, spay/neuter status, FIV/FELV status [for cats only] and where you got them from.
*
If you currently own a pet, do you have pet insurance?
yes
no
I do not currently own a pet
If you have personally owned animals before, please provide your veterinary reference: Provide Name, Address, Phone Number. Please inform your vet we will be calling.
If this animal will be your first pet, please provide the name, address and phone number of the veterinarian you plan to use in the future. (If you do not have one yet or are not sure, please say so and we can help you find one).
Please provide TWO personal references. We need their NAME and PHONE NUMBER. Name and phone number. ** Your references CANNOT BE FAMILY MEMBERS and they should be people who have been to your home.
*
It may take your new kitty two or more weeks to adjust to its new home. Are you prepared to allow this time to decompress if needed?
Yes
No
I hereby agree the above information is true and I authorize North Bergen Purr to contact those references listed above. I understand that the completion of this form is the first step in the adoption process and does not guarantee an adoption. North Bergen Purr reserves the right to make an in-home screening visit and to deliver the cat(s), if an adoption takes place, to ensure that I will provide a hazard-free home. If at any time and for any reason I cannot keep the animal I agree to return it to North Bergen Purr. I agree to pay the adoption fee via cash, venmo, or zelle on the day of the adoption.
Yes
No
Signature
Submit
Submit
Should be Empty: