Cat Adoption Application
Name of cat(s) interested in adopting (REQUIRED)
*
Applicant Information
Applicant’s Name
*
Partner’s Name
Address
*
Apartment/Unit Number
City
*
Postal Code
*
Primary Phone Number
*
Primary Phone Type
*
Home
Cell
Work
Secondary Phone Number
Secondary Phone Type
Home
Cell
Work
Partner's Phone
Email Address (if you do not have an email, please put noemail@noemail.com)
*
example@example.com
Emergency Contact Information
Please list an emergency contact that does not live in your household.
Emergency Contact’s Name
*
Relationship to Applicant
*
Phone Number
*
Household Information: Applicant
Complete the information for yourself below.
Are you 18+?
*
Yes
No
What is your occupation?
*
Working
Student
Other
Household Information: Household Members
List the names, ages, relationships, and occupations of each person living in your household including yourself.
Person 1: First & last name
Person 1: Are they 18+?
Yes
No
Person 1: Relationship to applicant
Person 1: Occupation
Working
Student
Other
Person 2: First & last name
Person 2: Are they 18+?
Yes
No
Person 2: Relationship to applicant
Person 2: Occupation
Working
Student
Other
Person 3: First & last name
Person 3: Are they 18+?
Yes
No
Person 3: Relationship to applicant
Person 3: Occupation
Working
Student
Other
Person 4: First & last name
Person 4: Are they 18+?
Yes
No
Person 4: Relationship to applicant
Person 4: Occupation
Working
Student
Other
Who will be the primary caregiver for this pet?
*
Does anyone in your household show signs of allergies to cats?
*
Yes
No
Sometimes
Unsure
Pet Ownership
Please list current and previous pets, including pets that have passed on. Select the appropriate response for each.
Pet 1: Name
Pet 1: Type & Breed
Pet 1: Spayed/ Neutered
YES
NO
Pet 1: Declawed
YES
NO
Pet 1: Indoor/ outdoor
IN
OUT
BOTH
Pet 1: Where is the pet?
Still own
Deceased
Other
Pet 1: Ownership
Childhood pet
My pet
Other
Pet 2: Name
Pet 2: Type & Breed
Pet 2: Spayed/ Neutered
YES
NO
Pet 2: Declawed
YES
NO
Pet 2: Indoor/ outdoor
IN
OUT
BOTH
Pet 2: Where is pet?
Still own
Deceased
Other
Pet 2: Ownership
My pet
Childhood pet
Other
Pet 3: Name
Pet 3: Type & Breed
Pet 3: Spayed/ Neutered
YES
NO
Pet 3: Declawed
YES
NO
Pet 3: Indoor/ outdoor
IN
OUT
BOTH
Pet 3: Where is pet?
Still own
Deceased
Other
Pet 3: Ownership
My pet
Childhood pet
Other
Pet 4: Name
Pet 4: Type & Breed
Pet 4: Spayed/ Neutered
YES
NO
Pet 4: Declawed
YES
NO
Pet 4: Indoor/ outdoor
IN
OUT
BOTH
Pet 4: Where is pet?
Still own
Deceased
Other:
Pet 4: Ownership
My pet
Childhood pet
Other
1. Have you ever had to give up an animal? If so, please explain the circumstances
*
2. In order to feed, provide medical and daily care for my new pet, I am prepared to spend the following per year:
*
3a. Please list the names of the veterinary clinics your pets have seen.
*
3b. When were their last vaccinations? (month and year)
*
4. Understanding that all cats may have unexpected medical needs, I am comfortable adopting a cat:
*
With no current health issues
Eating a vet prescribed diet
Taking medication
With ongoing medical conditions
5. How often do you plan to take your new cat to the vet?
*
Once every couple of years
Annually or more often
When sick
Not sure
6. What traits are you looking for in a cat? (check all that apply)
*
Gets along with other animals
Family friendly
Quiet, calm
Playful, active
Independent
Affectionate, cuddly
Likes to be pet
Shy, nervous
Confident
Vocal or chatty
Low shedding
Other
7. What behaviours are you NOT willing to work with, or situations that would cause you to return this animal? (check all that apply)
*
Vocal
Shedding
Inappropriate scratching
Rough playing/biting
Medical issues arise
Shy, hiding
Door dashing
Litter box issues
Fighting with other pets
Too time consuming
Messy or smelly
Other
8. I plan to declaw my new cat:
*
After adoption
If causing damage to property or injuries to my family
I will not declaw
Unsure, what is declawing?
9. I prefer my new cat to be:
*
Indoor only
Indoor/outdoor
Outdoors with supervision
Other
10. If your cat will have access to the outdoors, please describe what that may look like (e.g. in backyard, on leash, free access, enclosure)
*
11. Is there anything you would like more information on? e.g. scratch training, socializing, kitten proofing, etc
*
12. If I move, I will
*
Take it with me
Find it a new home
Give it to a family member
Surrender it to an animal shelter
Acknowledgement
By signing below:
I certify that I am at least 18 years of age and have the knowledge and consent of all adults living in my household.
I certify that the information I provide on this application is true and complete. I authorize the investigation of all stat
eme
nts contained on this
application and understand that the Humane Society of Oakville, Milton & Halton has the right to deny my request to adopt an animal.
I understand that this application is the property of the Humane Society of Oakville, Milton & Halton.
I understand that the Humane Society of Oakville, Milton & Halton may contact my veterinarian and I authorize access to any records held
by
that office in
regards to my current and past pets.
I would like to receive electronic communications from the Humane Society of Oakville, Milton & Halton, 445 Cornwall Road, Oakville, On. 905-845-1551. shelter@omhs.ca. I understand that I can unsubscribe at any time using the SafeUnsubscribe button at the bottom of every email. I would like to receive emails to the following email address:
example@example.com
Signature
*
Date
*
/
Month
/
Day
Year
Date
FOR OFFICE USE ONLY :
Animal Name(s)
SB#/Location
Adoption Phone Meeting
Adoption Pick-Up
Drivers Licence
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