Cat Adoption Form

Please Read, fill out form below, then press submit button.
Thank You. We look forward to hearing from you!

The cat/kitten you are adopting is spayed/neutered and up-to-date with shots. By submitting this application and contract, you agree:
You will never sell or give this animal to any research laboratory or similar facility.
You will keep the cat indoors.
If, for any reason, you cannot keep the kitten/cat, you will return it to ACT
(570-242-2846).
ACT reserves the right to reclaim the cat/kitten if it deems that this adoption is not in the best interests of the cat/kitten.
In the event you must give this cat to a shelter, you agree that you will only give the cat to a shelter with a no-kill policy.
ACT makes no representation or warranty regarding the health, disposition or any other quality of the animal or animals you examine prior to adoption or of the animal or animals you adopt. You confirm that you are sufficiently familiar enough with cats and other house pets to make your own judgments regarding their examination and adoption, you hereby waive to the extent permitted by applicable law, and agree not to assert, any claim against ACT or any person acting on its behalf or associated with it, on any theory of liability whatever, including without limitation, for special, indirect, consequential or punitive damages arising out of, in connection with or as a result of your proceeding toward the adoption of or your adoption and care of any animal from or through ACT, and you agree to indemnify and hold harmless ACT and any and all persons acting on its behalf from and against any and all losses, claims, damages, liabilities and related expenses, including fees and expenses of counsel, incurred by or asserted against it or any such person by yourself or any other person, whether or not related to you, in any way arising out of, in connection with or resulting from the condition, behavior or act of any such animal.

I have read the above stipulations and by entering in my name below agree to the conditions.

Full Name*

First NameLast Name

Personal Information

Full Name*

PrefixFirst NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Phone Number*

Area CodePhone Number

Employer's Name and Phone or Other

Driver's License (if you have one)

Are you over the age of 18?*

YesNo

Cat Information

Cat's Name you wish to adopt; if unknown, state unknown or give some details where you saw the cat (PetSmart ect.) If you are looking for a cat, but haven't seen one on our website, fill out form and we will contact you.*

Color*

Gender - Check one please*

MaleFemaleMale or Female, sex doesn't matter

Age of Cat (please state a range) example 1 to 2 years old, kitten, senior etc.*

Who is the cat/kitten for?*

Who will be primarily responsible for the care of the cat/kitten?*

Cats can live from 15 to 20 years, are you willing/able to make that commitment? If you would like a pet with a shorter commitment, consider a senior or older cat. They need homes and will love you just as much. Many of our older cats come from homes where the owner has passed away. They miss having companionship and would be a wonderful addition to your family.*

Housing

Will the cat be kept indoors?*

Where will the cat be kept?*

If renting, does your lease allow cats?*

What floor do you live on?*

Do you have a balcony or terrace?*

Is anyone in your home allergic to cats?*

Do you (or have you) own(ed) a pet? If yes, please let us know what type, how many and the current status of your pets (example are they living, deceased, etc.) Please know that vet care is important and you should find one ASAP if you have never owned a pet.*

If you have cats, have they been tested for FIV and Feline Leukemia? Please tell us the test results.*

Do you own a declawed cat?*

yesno

If you own cats, are they Spayed/Neutered?*

yesnoI don't currently have a cat

For the pets you do own, are shots up to date?*

yesno

Please fill in your Veterinarian's name, address and phone number. If you do not own a pet, please tell us who you intend to use as your vet.

Vet Full Name*

PrefixFirst NameLast Name

Vet Phone number*

Area CodePhone Number

Vet Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Have you ever relinquished a cat to an animal shelter? If yes, please explain and state name of organization and date of relinquishment.*

Cats/Kittens may damage items in your home or go to the bathroom outside the litter box. Please state your feelings about this.*

Has anyone in your home been convicted for an animal-related offense?*

As part of the pre-adoption process, ACT may require a house visit, will you allow ACT to visit your home?*

If, for any reason, you cannot keep the kitten/cat, you will return it to ACT (570-242-2846).

AgreeDisagree

Please Provide the names and numbers of 2 References. Please be aware that without references no adoption can take place.

First Reference Full Name*

First NameLast Name

First Reference Phone Number*

Area CodePhone Number

Second Reference Full Name*

First NameLast Name

Second Reference Phone Number*

Area CodePhone Number

Adoption Fees:

Kittens and Cats
1-6 years $85;
Cat 7-10 years $60;
Cat over 10 years $35;
Declaw $125;
Full Pedigree $175;
Mixed Pedigree $110,
Fees payable to ACT

Adoption Form for Cats