CARE Cat Adoption Application

Adoption Application
General Information
Name of Applicant*

First NameLast Name
Age of Applicant*
Applicants must be at least 21 years old to adopt
Name of Co-Applicant

First NameLast Name
Email Address*
example@example.com
Cell Number*
Alternative Phone Number
Employment*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
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.
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
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 Housing
Do you own or rent your home?*

OwnRentI live with a parent, guardian or family member
Do you plan to move in the foreseeable future?

YesNoUnsure
If you rent or live in a family member's home, please provide their contact information here:
Who else lives in the home or visits regularly? Please list names and ages for individuals under 18 years of age.*
Ex: Michael, husband (41); Jessica, daughter (7). 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.*
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 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?*

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
Are you willing and able to care for your cat for the full duration of its life (15-20+ years)?*

YesNo
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.
Vet Clinic*
Vet Clinic Phone*
Last name that the pet(s) are listed under (if applicable):*
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 21 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 The Little Ones- Kitten Rescue.*

AgreeDisagree
I understand that The Little Ones- Kitten Rescue has the right to deny any application for any reason*

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 The Little Ones- Kitten Rescue by phone and/or email to discuss return/or need for help of the adopted animal.*

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
I hereby authorize The Little Ones- Kitten Rescue to contact my references, veterinarian(s), and landlord to verify said statements.
Applicant Name*

First NameLast Name
Signature*

Powered by Jotform SignClear
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

Adoption Application

General Information

Home & Family

Current & Past Pets

Veterinarian

Personal References

Terms & Conditions