Big Apple Cats Adoption Application

Where did you find this application? (website, adoption event, instagram, email, etc)

Today's Date:

Date

Name of cat/kittens you are interested in. If no specific cat, do you want a pair or a single?

Your Name

Home Phone

Format: (000) 000-0000.

Street Address and Apt #

City, State, Zip

Work Phone

Format: (000) 000-0000.

E-mail

example@example.com

How long have you lived at this address?

Do you own or rent?

If renting, when does your lease expire?

If renting, have you confirmed that animals are permitted in your building?

YesNo

Does your home have a terrace?

YesNo

Does your home have a backyard?

YesNo

Does your home have screens on the window?

YesNo

Please provide name, relationship and ages of everyone currently living in your household:

Rows	Name/Relationship to you	Age	Name/Relationship to you	Age

Does anyone in the home have allergies to animals?

YesNo

if yes, please (specify)

Are you adopting the animal for yourself or for someone else?

What is your age?

Do you know that cats can live fifteen or twenty years?

YesNo

Are you ready to make such a long term commitment?

YesNo

Do you know that cats can live fifteen or twenty years?

YesNo

Under what circumstances would you choose to give up your cat?

Please provide the following information for each animal companion CURRENTLY living in your household:

Rows	Animal Name	Type/Breed	Age & Sex	Spayed/Neutered?

Have you ever had a companion animal before (not including current animals listed above)? If yes, please provide any relevant information about the animal(s), including why they are no longer with you:

CURRENT & PREVIOUS ANIMALS (cont

Have you ever had to give up or re-home an animal? If yes, what were the circumstances?

Please provide your Veterinarian’s Name & Practice

Veterinarian’s address

Veterinary Practice Phone

Format: (000) 000-0000.

Please supply TWO personal references:

Name

Relationship

Email

example@example.com

Phone

Format: (000) 000-0000.

Name

Relationship

Email

example@example.com

Phone

Format: (000) 000-0000.

What is your current occupation?

Who is your current employer?

How long have you worked there?

Employer Address

Employer Phone

Format: (000) 000-0000.

Please supply ONE business reference (If you don't have a business reference you can put a third personal reference):

Name

Relationship

Email

example@example.com

Phone

Format: (000) 000-0000.

Previous Employer

Previous job title

How long did you work there?

Does your current job require extensive travel?

YesNo

How many weeks/months per year do you travel for work and recreation?

What arrangements will you make for the care of your companion animal when you travel on business or vacation?

Would you prefer to adopt a declawed cat?

yesno

Would you prefer to adopt a cat who can catch mice?

yesno

How did you find out about Big Apple Cat’s adoptions?

By signing below, I certify that the above information is true, and I authorize Big Apple Cats with permission to contact references and verify the information that I have provided herein. I understand that the completion of this pre-adoption application is only the first step in Big Apple Cat's companion animal adoption process, and does not guarantee any adoption of any animal to me by Big Apple Cats. Big Apple Cats reserves the right to make an in-home screening visit and to deliver any adopted animal, in order to further assess the likelihood that I will provide them with a hazard-free home.

Date

PRE-ADOPTION APPLICATION

HOUSEHOLD INFORMATION

CURRENT & PREVIOUS ANIMALS

REFERENCES