Cat Adoption Application

Second Chance Animal Center

CAT ADOPTION APPLICATION
Depending on when this application is received and any landlord or veterinary checks we need to complete, processing can take 2-4 days. We will contact you via email with your application result.
Adopter's Information
Name

First NameLast Name
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mailing Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Background Information:
Adopting a cat brings with it a lot of responsibility, including annual veterinarian visits, vaccinations, and possible emergency care. This is more expensive than many people realize. Are you aware of and prepared to assume the responsibilities for your newly adopted cat?*

YesNo
I currently own a*
For how long?
I currently rent a*
For how long?
Landlord's Name

First NameLast Name
Landlord's Phone Number

Area CodePhone Number
I currently live with family or friends in a
For how long?
Home Owner's Name

First NameLast Name
Home Owner's Phone Number

Area CodePhone Number
Are you a first-time cat adopter as an adult?

YesNo
If NO, how many cats have you lived with?
If No, how many cats have you lived with?
List Veterinarian References:
Have you ever adopted from SCAC before?*

YesNo
If yes, what type of animal?
Year?
Have you ever surrendered an animal to SCAC before?*

YesNo
Why?

List all pets currently in your household or pets you have owned in the last 5 years.

	Animal's Name	Type/Breed	Spayed/Neutered?	Owned how long?	Still own?	If no, what happened?

I also live with

Other petsChildrenOther adults
Describe any other pets:
How many children and ages:
Other adults, how many?
Do you or anyone in your family suffer from pet/animal allergies?

YesNo
Your New Cat: Physical Traits
Gender of cat you're looking for?

MaleFemaleDoesn't matter
Age range you're looking for?

KittenYoung AdultAdultSeniorDoesn't matter
Looking for a declawed cat?

YesNo
Preferred hair length?

ShortMediumLongDoesn't matter
Do you plan to declaw your new cat?

YesNo
Your New Cat: Other Traits
What role would you like your new cat to play in your life?

Companion/family petBarn catOther (please describe below)
Describe role you would like cat to play:
What traits would you like most in your new cat. (Check all that apply)

EnergeticAffectionateSedateCuriousShyQuietAloofTalkativeLap CatBoldFriendlyQuickly AdaptableOther (please describe below)
Describe other traits you would like your cat to have:
What behaviors would you have a hard time dealing with in your new cat? (Check all that apply)

Inappropriate ClawingEscaping BehaviorScratchingBitingStubbornPoor MouserNervousNot Good with other petsPoor litterbox habitsDigs in plants/gardenAloofPlays rough with childrenToo energeticNoisy/Meows a lotShyGets on the furniture/coungterOther (please describe below)
Description of other traits you'd find hard to deal with:
If your new cat displays behavioral problems - such as poor litterbox habits, inappropriate scratching, etc., how would you go about teaching him/her?

Contact a professionalUse a bookPersonal knowledgeCall SCAC for adviceOther (please describe below)
Other description of how you would go about teaching your new cat:
Life at Your Home
Would you classify your home as:

CalmSome activityExtremely busy
What type of cat do you envision yourself owning?

Quiet & CalmModerately ActiveConstant Energy
Would your new cat be living with or have any of these as neighbors or visitors? (Check all that apply)

Children under 10TeenagersOther cats (female)Other cats (male)DogsBirdsRabbits/RodentsPoultryLivestock
How many hours a day will your cat spend indoors?
How many hours a day will your cat spend outdoors?
About how much time during the day will your cat spend alone; unsupervised without a human?
Where will your cat spend the night?
In the shelter environment, it's difficult for us to determine if a cat is litterbox trained. Would you be able to tolerate a few accidents?

YesNo
What kind of solutions would you be willing to try if housebreaking accidents continue after the first week? (Check all that apply)

Move litterbox to a new locationTry different litterAdd another litterboxClean litterbox more oftenHave the cat examined by a veterinarianInstall a cat doorNone of the aboveOther (please explain below)
Other things I would try if housebreaking accidents continue:
Applicant Signature
I certify that the above information is true and correct to the best of my knowledge and that I understand that false information may result in the nullification of this adoption or return of the animal to SCAC. We reserve the right to refuse any adoption for any reason. This completed profile is the property of SCAC and is not to be removed from the SCAC files without the explicit approval of the Executive Director.

Clear
Parent/Guardian's Signature if under 18 years of age

Clear
Authorization to Release Information
Name of Veterinarian:

First NameLast Name
Name of Landlord:

First NameLast Name
Applicant's Printed Name:

First NameLast Name
Applicant's Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
By my signature below, I authorize SCAC to check my landlord and veterinarian references provided *

YesNo
Signature:

Clear
Should be Empty:

Second Chance Animal Center

Adopter's Information

Background Information:

Your New Cat: Physical Traits

Your New Cat: Other Traits

Life at Your Home

Applicant Signature

Authorization to Release Information