Cat Adoption Application Form

Expression of Interest to Adopt
This form is an expression of interest to adopt only. Canberra Street Cat Alliance makes no guarantee that by expressing interest in a cat or kitten that you will be able to adopt that or any cat/kitten from Canberra Street Cat Alliance. Normal checks and procedures apply however Canberra Street Cat Alliance may rely on information in this form as part of its decision.

Please note due to the number of expressions of interest we receive we cannot always reply individually.

Please carefully read the Terms and Conditions at the bottom of this form.
Personal Details
Prospective Cat Parent 1*

First NameLast Name
Prospective Cat Parent 2

First NameLast Name
Name/s of Cat *
If you do not have a specific cat in mind, just write 'no specific'
Phone number*
Email Address*
Residential Address*

Street Address

Street Address Line 2

CityState

Post Code

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo
If you answered "Yes" please provide a detailed description:
Are there children in the home? (If yes, please list ages)*
How many hours per day would the cat be alone?*
If you have to leave town, unexpectedly or planned, where would your pet stay?*
etc. Housemates would care for him/her, ABC Boarding Kennel, With Family, Would Ask neighbours to check in

Please tell us about why you think you would be a great home.

Terms and Conditions
General Terms and Conditions

By clicking the submit button I, {perspectiveCat}, declare that I:
- am over 18 years of age and have permission from landlord, parent or other where applicable to house a cat and/or kitten at the premises I reside.
- verify the information contained in this form is true and accurate.
- understand that the information provided in this form will be used as part of the adoption application process.
- understand that I am submitting an expression of interest in adoption only, and that Canberra Street Cat Alliance (CSCA) makes no guarantee to proceed with an adoption.
- agree to the CSCA adoption process including undergoing a home-check and interview at the discretion of CSCA.
- understand CSCA may check my references including veterinary and personal.
- understand that prospective families are chosen as a best-fit for the cat.
- agree to update CSCA by email if at any time while I wish to be considered as a prospective adopter the information submitted in this form changes or I become aware that it is no longer accurate.
Adoption Specific Terms and Conditions

By clicking the submit button I, {perspectiveCat}, declare that I:
- understand that if I am offered an adoption I am under no obligation to accept the offer.
- understand there is an adoption fee associated with adoption of a pet from CSCA and that it is NOT tax deductible. I understand this fee will ensure the organisation is equipped to rescue another homeless cat and/or kitten.
- understand there is a 14 day trial period, unless otherwise specified, and that during this period CSCA remains the owner of the cat/s.
- understand that if during the trial adoption the cat/s become sick I will immediately inform CSCA.
- If, during the trial period, there are any medical concerns for the kitten/cat, it must be taken to a vet. CSCA will cover vet costs, including diagnostic fees for a recurrence of symptoms of any underlying medical condition or illness that was present while the cat was in foster care. CSCA will also cover costs for the treatment of any illness that may have been present during foster care. CSCA will not guarantee to cover any vet costs that are incurred as a result of an issue that was evidently caused while in the care of the Adopter
- if during this period I no longer want or can no longer care for my adopted pet, I agree to notify CSCA Alliance BY EMAIL and provide a 14 day period to allow Canberra Street Cat Alliance to make arrangements for my pet to be taken back into rescue.
- agree to indemnify and hold harmless CSCA against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
- understand that CSCA will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
- understand that CSCA cares about all the cat/s and kittens that it rehomes and would like to be given the first opportunity to rehome the cat/s, if after the adoption is complete and ownership has been transferred to me, I no longer want my cat, or am no longer able to care for my cat/s.
Signature*

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