CARE Cat Adoption Application

Another Chance Animal Rescue Cat Adoption Application Form

General Information

Home & Family

Current & Past Pets

Veterinarian

Personal References

Terms & Conditions

Another Chance Animal Rescue Cat Adoption Application Form
General Information
Name of Applicant*

First NameLast Name
Age of Applicant*
Applicants must be at least 21 years old to adopt
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.
Employment*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Kitten(s)AdultSeniorUndecided / no age preference
Yes - I am applying for a cat I saw at Petsmart/pet supplies plusYes - I am applying for a cat I met at the shelter / in a foster homeYes - I am applying for a cat that I saw on FacebookNo - I am still considering all options
Which cat(s)/kitten(s) are you interested in adopting?*
List the name(s) of all cats you're interested in
Describe the type of personality and/or appearance you would like your cat to have:
Ex: playful, friendly, lap cat, good with kids, good with other dogs, male, orange etc.
MyselfMy familyRelativeFriendOther
YesNo
YesNo
YesNo
Are you looking to adopt now, or in the future? *
If future, please provide an estimate as to when you'll be ready to bring home your new cat
Home & Family
Single-FamilyApartmentCondo/DuplexPublic HousingStudent Housing
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:
BusyQuietA mix of both, depending on the time & day
YesNoMaybe
Current & Past Pets
YesNo

YesNo - this is my first pet
Do you plan to let your cat out for outdoor time? If so please explain.*
YesNoN/A - this is my first pet
YesNoI don't know
YesNo
YesNo
How many hours per day would the cat be alone?*
How would you deal with behavioral issues such as excessive meowing, destructive behavior, inappropriate urination etc.?
YesNo
YesNo
If you have to leave town, urgently or planned, where would your cat stay or who would take care of it?*
If you were no longer able to care for your pet, or had to move, what would happen to your pet?*
YesNo
If you answered "Yes" to the above question, please explain the circumstances:
YesNo
If you answered "Yes" please provide a detailed description:
YesNo
Veterinarian

Please list your current / previous / planned veterinarian(s) and their phone number(s).
Vet Clinic*
Vet Clinic Phone*
Format: (000) 000-0000.
Last name that the pet(s) are listed under (if applicable):*
Previous Vet Clinic
Previous Vet Clinic Phone
Format: (000) 000-0000.
Personal References

Please provide 2 non-family references (eg. neighbors, coworkers, family friends etc.)
Reference 1*

First NameLast Name
Reference 1*
Format: (000) 000-0000.
Relationship to Reference 1*
Ex. Neighbor, coworker, roommate, family friend
Reference 2*

First NameLast Name
Reference 2*
Format: (000) 000-0000.
Relationship to Reference 2*
Ex. Neighbor, coworker, roommate, family friend
Terms & Conditions
AgreeDisagree
AgreeDisagree
AgreeDisagree
AgreeDisagree
AgreeDisagree
AgreeDisagree
AgreeDisagree
AgreeDisagreeN/A - I don't have any cats currentlyN/A - the cat I am applying to adopt has already been FeLV tested
I hereby authorize Another Chance Animal Rescue to contact my references, veterinarian(s), and landlord to verify said statements.
Applicant Name*

First NameLast Name
Signature*
Date*

MonthDayYear
Date
Should be Empty:

Type of Animal

Fixed? (Y/N)

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