NYCCC Adoption Application

NYCCC Adoption Application

Complete the adoption application using the exact fields, labels, options, and order from the PDF. Fields default to optional unless clearly required in the source.
Applicant Information
Name of Cat(s) Requested
Name (Person 1)
First and last name
Name (Person 2)
First and last name
Age (Person 1)
Age (Person 2)
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
If Person 1 and Person 2 no longer live together whom will assume ownership / responsibility for the pet?
How long have you lived at this address?(if less than 2 years please provide previous address below)
Previous address if you have lived at above address less than 2 years
Home Phone Number
Cellular Phone Number
Email
example@example.com
Employer (Person 1)
Employer (Person 2)
Employer Address (Person 1)
Employer Address (Person 2)
How long have you been with this company? (Year? Month?) (Person 1)
How long have you been with this company? (Year? Month?) (Person 2)
Do you own or rent your current residence?

Other
Does your lease permit pets

Other
If renting, when does your lease expire?
Name of Landlord or Renting agent
Landlord or Renting Agent phone number
Are you adopting for yourself or someone else?

Other
Adoption Suitability and Household Details
Why are you adopting a cat at this point and time?
Do you have others living in your home?
If yes, who?
Does anyone in your family have allergies to animals?
If yes, who?
Have you had pets before?
If yes, what kind?
Are there any other animals in your home now?
If yes, what kind?
How many?
Age of pet?
Where did you get the pet?
How long have you had the pet?
Pet's name
Pet will be kept
If outdoors, where?
If indoors, where?
Will pet be allowed on furniture?
Will pet be allowed in bedroom?
Do you have a terrace?
Do you have a backyard?
Where did you learn about us?
Does your current job require extensive travel?
References and Emergency Caretaker
Personal Reference - Name

First NameMiddle NameLast Name
Personal Reference - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Personal Reference - Relationship
Personal Reference - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Custodian if you could no longer care for pet(s) - Name

First NameMiddle NameLast Name
Custodian if you could no longer care for pet(s) - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Custodian if you could no longer care for pet(s) - Relationship
Custodian if you could no longer care for pet(s) - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferences
Would you prefer a declawed cat?
Will you declaw (permanently remove claws surgically)
Do you need a cat to catch mice?
Pet will be kept?
Do you want a cat that can travel well in a car?
Do you want a cat that will sleep in bed with you?
Describe what type of personality traits you want in a cat
Do you currently have a Veterinarian? ( if no list previous vet below instead)
Veterinarian Phone Number
Veterinarian Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Previous vet
Certification

I certify that all of the above information is true and accurate and I authorize the Representatives of NYC Cat Coalition to contact those listed above. I understand that if I adopt a cat/kitten from the NYC Cat Coalition and it is later discovered that I have falsified any information on the application, the adoption will be null and void and I must return the cat/kitten(s) to the NYC Cat Coalition. I acknowledge that I am 21 years of age or older, will provide identification showing my current legal address and that I have the knowledge and/or consent of my landlord.
Date

MonthDayYear
Date
Should be Empty:

NYCCC Adoption Application

Applicant Information

Adoption Suitability and Household Details

References and Emergency Caretaker

Preferences

Certification