Barn Buddy Adoption Application
Please note: when applying to adopt, please only complete ONE application form per household.
Please note: Barn Buddy cats do NOT appear on our website under the adoptable cat section. Applicants can apply for a Barn Buddy, and our team will match you with the cat most suitable for your living environment. For more information prior to applying, please contact us at 905-845-1551 or adoptions@hsomh.ca
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I understand
Applicant Information
Applicant’s Name
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Partner’s Name
Address
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Apartment/Unit Number
City
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Postal Code
*
Primary Phone Number
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Format: (000) 000-0000.
Primary Phone Type
*
Home
Cell
Work
Secondary Phone Number
Format: (000) 000-0000.
Secondary Phone Type
Home
Cell
Work
Partner's Phone
Email Address (if you do not have an email, please put noemail@noemail.com)
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example@example.com
Household Information: Applicant
Complete the information for yourself below.
Are you 18+?
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Yes
No
What are your living accommodations:
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House
Apartment
Mobile Home
Other
Do you:
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Rent
Own
If you rent, what is your landlord's name and phone number:
Do you live here full time?
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Yes
No
Please describe your property, including size:
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Please describe the structure in which the cat will be housed:
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How far from the road/traffic is your barn located?
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Volume of traffic:
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Low
Medium
High
What is the speed limit on your road?
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Is your farm a working farm or hobby farm?
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Pet Ownership
Have you had pets before?
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Yes
No
Do you have any pets of your own currently?
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Yes
No
Please list any pets that you have owned.
Pet 1: Name
Pet 1: Type & Breed
Pet 1: Age & Sex
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: Where did you get this pet
Pet 1: Years owned
Pet 2: Name
Pet 2: Type & Breed
Pet 2: Age & Sex
Pet 2: Spayed/ Neutered
YES
NO
Pet 2: Declawed
YES
NO
Pet 2: Indoor/ outdoor
IN
OUT
BOTH
Pet 2: Where did you get this pet
Pet 2: Years Owned
Pet 3: Name
Pet 3: Type & Breed
Pet 3: Age & Sex
Pet 3: Spayed/ Neutered
YES
NO
Pet 3: Declawed
YES
NO
Pet 3: Indoor/ outdoor
IN
OUT
BOTH
Pet 3: Where did you get this pet
Pet 3: Years Owned
Pet 4: Name
Pet 4: Type & Breed
Pet 4: Age & Sex
Pet 4: Spayed/ Neutered
YES
NO
Pet 4: Declawed
YES
NO
Pet 4: Indoor/ outdoor
IN
OUT
BOTH
Pet 4: Where did you get this pet
Pet 4: Years Owned
What happened to the pets you no longer have?
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Animal Care Information
Why do you want a barn cat?
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Barn cats must be securely confined for 2-4 weeks. Do you have an area of the barn that is secure to do this?
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Yes
No
Are you prepared to allow for this much time?
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Yes
No
Who will be responsible for your barn cat's care?
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Who will care for your barn cats if you are away?
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Do you plan to provide the cat with fresh water and food daily?
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Yes
No
Do you agree to trap or contain your barn cat in a carrier and take it to the vet should it become ill or injured?
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Yes
No
Please provide the name of your small animal vet:
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What other types of animals will the cats share the barn with?
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Do you currently have barn cats?
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Yes
No
Are they spayed/neutered?
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Yes
No
If you have a dog is he permitted to run loose?
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Yes
No
Don't have a dog
If yes, what provisions will be made to protect the cats?
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
Completed Review
SB Check
Address verified
Continue
Continue
Should be Empty: