CARE Cat Adoption Application

Cat/KittenAdoption Application
General Information
Name of Applicant*

First NameLast Name
Age of Applicant*
Applicants must be at least 18 years old to adopt
Email Address*
example@example.com
Cell Number*
Alternative Phone Number
Employment*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What type of cat are you interested in adopting? Check all that apply.*

Kitten(s)AdultSeniorUndecided / no age preferenceBARN CAT PROGRAM
Are you interested in adopting a specific cat?*

YesNo - 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.
If the cat(s) you are interested are no longer available for adoption, would you like us to continue to process your application for pre-approval in the event that another cat interests you?*

YesNo
Who is this pet for?*

MyselfMy familyRelativeFriendOther
Are all members of the household aware of the adoption and in agreement?*

YesNo
Have you applied to adopt from us previously?*

YesNo
Have you adopted from us previously?*

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
Describe your home*

Single-FamilyApartmentCondo/DuplexPublic HousingStudent HousingFarm/RanchCamper/nomadic
Do you own or rent your home?*

OwnRentI live with a parent, guardian or family member
Who else lives in the home? Please list names and ages for individuals over 18 years of age.*
Ex: Michael, husband (41); Susan, mother-in-law (80).
Is your home busy or quiet?*

BusyQuietA mix of both, depending on the time & day
Are any members of the household allergic to pets (eg. dogs, cats etc.)*

YesNo
If you had to move, are you willing to find housing that accepts pets?*

YesNoMaybe
Current & Past Pets
Do you have any pets currently?*

YesNo

Have you had any pets of your own in the past 10 years?*

YesNo - this is my first pet

Have you ever had a pet euthanized?*

YesNo
If yes, please explain the circumstances:
Have your current or past cats been mostly indoor with some time spent outdoors? How often did they go out? Please explain:*
Do you plan to let your cat out for outdoor time? If so please explain how you will keep them safe.*
Did you declaw any of your past or current cats?*

YesNoN/A - this is my first pet
Do you plan on declawing your adopted cat?*

YesNoI don't know
Are you willing/able to take your pets to yearly check-ups?*

YesNo
If your pet becomes ill, are you able to afford a veterinary bill?*

YesNo
How many hours will your cat be alone?*
If Barn cat Program put Barn Cat Program in Field
How would you deal with behavioral issues such as excessive meowing, destructive behavior, inappropriate urination etc.?*
Does your home have space (i.e. a spare bedroom, office, or bathroom) to separate new pets from current pets during the acclimation and introduction period?*

YesNo
Are you willing to give your cat/kitten time to adjust to its new environment? (Note: this could take anywhere from several days to several months)*

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?*
Have you ever had to re-home a pet or surrender it to an animal shelter, animal control etc.?*

YesNo
If you answered "Yes" to the above question, please explain the circumstances:
Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo
If you answered "Yes" please provide a detailed description:
Are you willing and able to care for your cat for the full duration of its life (15-20+ years)?*

YesNo
Barn Cat Program
Describe the housing/shelter provided for Barn cats*
If not interested in barn cats put N/A
What will be their water and food source?*
Fresh water and Food(mice,birds,etc doesn't count as food) must be provided daily.
Are you aware that the cats will need to be contained safely for at least 2 wks prior to releasing them into the barn/farm areas?*

YesNoNot adopting Barn Cat
Are you willing and able to provide safe containment for at least 2 wks while the cats adjust to their new surroundings and home?*

YesNoNot adopting Barn Cat
We understand that barn cats are working cats, but they still deserve proper care, protection, vetting, and humane treatment. Will you/are you able to provide all the things listed above and insure that all workers/volunteers/property managers/animal caregivers will also treat the cats in a humane and ethical manner at all times?*

YesNoNot adopting Barn Cat
Veterinarian

Please list your current / previous / planned veterinarian(s) and their phone number(s). We will contact them to verify your current pets are up to date on shots, fixed and FeLV tested; this is a requirement for new pet adoptions. If you are planning to utilize another vet but are not currently a client, please note that information.
Vet Clinic*
Vet Clinic Phone*
Last name that the pet(s) are listed under (if applicable):*
Previous Vet Clinic
Previous Vet Clinic Phone
Personal References

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

First NameLast Name
Reference 1*
Relationship to Reference 1*
Ex. Neighbor, coworker, roommate, family friend
Reference 2*

First NameLast Name
Reference 2*
Relationship to Reference 2*
Ex. Neighbor, coworker, roommate, family friend
Terms & Conditions
I certify that I am at least 18 years of age*

AgreeDisagree
The information I have provided on this application is true. I also recognize that any misrepresentation or omissions may result in the loss of privilege to adopt from Fluffs Sake Cat Rescue INC.*

AgreeDisagree
I understand that Fluffs Sake Cat Rescue INC has the right to deny any application for any reason*

AgreeDisagree
I understand that Fluffs Sake Cat Rescue INC is not able to guarantee the health or temperament of any cat, as many cats come in with unknown histories. There are traits that could change upon adoptions and I take responsibility to care for and address these issues if they do arise*

AgreeDisagree
I understand that anything could happen in life, and if I find that I am no longer able to care for my adopted cat, I agree to contact Fluffs Sake Cat Rescue INC by phone and/or email to discuss return/or need for help of the adopted animal*

AgreeDisagree
I understand that I am to immediately contact Fluffs Sake Cat Rescue INC in the event that my adopted cat is lost/missing*

AgreeDisagree
I attest that the cat I am adopting is for me, in my Home or on my Farm/Ranch, and NOT a gift for anyone*

AgreeDisagree
I understand that I am responsible for paying for all follow-up vaccines, wellness visits & medical procedures my pet will require in the future.*

AgreeDisagree
If I am adopting a kitten that is too young to be fixed (foster-to-adopt), I understand that I am to keep it separate from my other cats until it is fixed, FIV/FeLV tested.*

AgreeDisagreeN/A - I don't have any cats currentlyN/A - the cat I am applying to adopt has already been altered
I hereby authorize Fluffs Sake Cat Rescue INC to contact my references, veterinarian(s), and landlord to verify said statements.
Applicant Name*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

	Name	Type of Animal	Sex (M/F)	Age	Fixed? (Y/N)	Up-to-date on vaccines? (Y/N)
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5

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

Cat/KittenAdoption Application

General Information

Home & Family

Current & Past Pets

Barn Cat Program

Veterinarian

Personal References

Terms & Conditions