Cat Adoption Application Form
Please note that there are no "right" or "wrong" answers. Your honest responses to these questions will help us to ensure that the best match is made for both you and your new family member.
General Information
Name of Applicant
*
First Name
Last Name
Date of Birth of Applicant
*
Applicant must be at least 21 years of age to adopt
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
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Name of Co-Applicant
First Name
Last Name
Address of Co-Applicant if different
Are you interested in adopting a specific cat?
*
Yes - I am applying for a cat I saw online
Yes - I am applying for a cat I met at the rescue / in a foster home
No - I am still considering all options
Which cat(s) are you interested in adopting?
List the name(s) of all cats you're interested in
Who is this pet for? (Check all that apply)
Myself
My family
A relative
A friend
Other
Are all adult members of the household aware of the adoption and in agreement?
*
Yes
No
Have you applied to adopt from us previously?
*
Yes
No
Have you adopted from us previously?
*
Yes
No
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-Family
Apartment
Condo/Duplex
Public Housing
Student Housing
Other
Do you own or rent your home?
*
Own
Rent
I 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:
How many adults live in the home?
Please list ages for any children (under 18) who live in the home or visit regularly.
*
How would you describe your home?
Busy/lots of activity
Mostly quiet
A mix of both, depending on the time & day
Are any members of the household allergic to cats
*
Yes
No
If you had to move, are you willing to find housing that accepts pets?
*
Yes
No
Maybe
If you chose maybe, please explain
Current & Past Pets
Do you have any pets currently?
*
Yes
No
List all current household pets. If you have more than 7, continue to list each in the box below, along with the asked for information.
Rows
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
Pet 6
Pet 7
If you currently have more than 7 pets in the home, please list below.
List all previous pets that you no longer have (within last 5 years) If you had more than 7, continue to list each in the box below, along with the asked for information.
Rows
Name
Type of Animal
Sex (M/F)
Why don't you have them any longer?
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5
Pet 6
Pet 7
If you had more than 7 previous pets, please list below.
Have your current or past cats been:
Indoor only
Indoor, with catio or walks on a harness
Mostly indoor, with occasional unsupervised outdoor time
Indoor/Outdoor
Other
If you checked other, please explain
Do you plan to let your cat out for outdoor time? If so please explain.
*
Did you declaw any of your past or current cats?
*
Yes
No
N/A - this is my first pet
Do you plan on declawing your adopted cat?
*
Yes
No
I don't know
Are you willing/able to take your pets to yearly check-ups?
*
Yes
No
If your pet becomes ill, are you able to afford a veterinary bill?
*
Yes
No
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.?
*
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?
*
Yes
No
Are you willing to give your cat time to adjust to its new environment? (Note: this could take anywhere from several days to several months)
*
Yes
No
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/s, what would happen to them?
*
Have you ever had to re-home a pet or surrender it to an animal shelter, animal control etc.?
*
Yes
No
If you answered "Yes" to the above question, please explain the circumstances:
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. Please call their office(s) to authorize release of information to us. If you are planning to utilize another vet but are not currently a client, please note that information.
*
If veterinary records are under a name/s other than the applicant name/s given on this form, please list. (Consider last name changes, whether a relative or spouse has brought your pets in, etc)
Terms & Conditions
I certify that I am at least 21 years of age
*
Agree
Disagree
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 ElderPaw Rescue
*
Agree
Disagree
I understand that ElderPaw Rescue has the right to deny any application for any reason
*
Agree
Disagree
Applicant Name
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: