Cat Chance Adoption Application Form

C A T C H A N C E

A P P L I C A T I O N F O R C A T A D O P T I O N
Date*
YYYY-MMM-DD (e.g., 2021-May-15)
Name of Cat You Wish to Adopt*
If open to any cat, write "Any"
Colouration or Pattern
(e.g., brown tabby, calico, tortie, black, etc.)
Age of Cat
Specified in Available for Adoption Album
Age Range Considered
If open to any cat, write "Any"
A P P L I C A N T I N F O R M A T I O N
Applicant Name*

First NameLast Name
Email Address*
Primary Phone*

Area CodePhone Number
Secondary Phone

Area CodePhone Number
Applicant Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Applicant Date of Birth
YYYY-MMM-DD (e.g., 1980-May-15)
Employment*

EmployedUnemployedRetiredStudentOther
Number of people in household*
#
Ages of children in household
#, #...
Is anyone in your household allergic to pets?*

YesNo
Does anyone in your household smoke?

YesNo
C O - A P P L I C A N T I N F O R M A T I O N
Name

First NameLast Name
Relationship
(e.g., daughter, partner, brother, etc.)
Email Address
example@example.com
Co-Applicant Phone

Area CodePhone Number
Co-Applicant Date of Birth
YYYY-MMM-DD (e.g., 1980-May-15)
Employment

EmployedUnemployedRetiredStudentOther
G E N E R A L I N F O R M A T I O N
Type of Residence*

HouseApartmentCondoMobile HomeFarm/BarnOther
If rental, are cats allowed?

YesNo
Complex Name
Manager/Landlord

First NameLast Name
Phone Number

Area CodePhone Number
Type of Street*

Very Busy RoadModerate TrafficSlight TrafficResidential AreaCountry RoadOther
Speed Limit
km/h
Where will the cat(s) live?*

Inside OnlyMostly InsideMostly OutsideOutside Only
Where will the cat(s) spend nights?*

Inside OnlyOutside Only
Will you allow the cat(s) to run loose?*

Yes, InsideYes, Outside
What area will be accessible to the cat(s) when you are at home?*

Indoors (entire space)Specific Area Indoors (room/crate)Outdoors (entire space)Specific Area Outdoors (shelter/barn)Other
What area will be accessible to the cat(s) when you are away from home?*

Indoors (entire space)Specific Area Indoors (room/crate)Outdoors (entire space)Specific Area Outdoors (shelter/barn)Other
How many hours per day will the cat(s) be alone?*
(e.g., #, range, infrequently, etc.)
What is the activity level in your home?*

Busy (visits from friends, meetings, children, parties at home)Noisy (TV, stereo, machinery, children playing, dogs barking)Moderate (normal comings and goings, occasional visits)Quiet (homebodies, few guests)Other
In the absence of the Primary Caregiver, who will care for the cat(s)?*
(e.g., family member, neighbour, friend, etc.)
If you have to leave town, unexpectedly or planned, where would your pet stay?*
(e.g., at friend's house, at home with family member, cat sitter, pet boarder, etc.)
Do you consider your cat(s) to be a part of your family?*

YesNo
Are you aware that a cat is a large and long commitment?*

YesNo
Have you ever surrendered a pet you own to an animal shelter?*

YesNo
Under what circumstances would you return the cat(s) to Cat Chance?*

New JobNew BabyDivorce/SeparationMoveIllnessPet ConflictOther
Are you willing to take responsibility if this cat acquires an illness?*

YesNo
Are you willing and able to pay the veterinary costs of caring for your new cat(s)?*

YesNo
Would you take your cat(s) to the vet to be spayed/neutered, if not already fixed?*

YesNo
Would you declaw your cat(s)?*

YesNo
How would you deal with problem behaviours such as clawing, scratching, biting, bathroom accidents, and hiding? What issues would not be tolerated in your household?*
Pet name, type/breed, age
How much time will you allow for your new cat(s) to adjust to your home?*
(e.g., days, weeks, years, however long it may take, etc.)
P E T I N F O R M A T I O N
Have you had any pets in the last five years?*

YesNo
Are there other pets currently living in your household?*

YesNo
In order from youngest to oldest, please list your current pets
Pet name, type/breed, age
Do any of your pets have special requirements or take medication?
(e.g., blind, diabetic, Pica disorder, aggression, raw food diet, etc.)
Are these pets spayed/neutered?*

YesNoN/A
Where do these pets live?*

Indoors OnlyIndoors/OutdoorsOutdoors OnlyN/A
Please list any previous pets and the reasons they are no longer with you
Pet name, type/breed, age, reason (move, divorce, death)
Current Vet or Clinic
Name of Vet or Clinic (if none, write "N/A")
Vet Clinic Phone

Area CodePhone Number
C A T C H A N C E I N F O R M A T I O N
How did you hear about Cat Chance?*

Social Media (facebook, instagram, etc.)Buy-or-Sell Site (kijiji, etc.)Word of MouthFriend or Family MemberOther
Would you be interested in contributing more to Cat Chance's efforts?*

Yes, by donating cash or suppliesYes, by trapping community catsYes, by fostering community catsYes, by helping with social mediaYes, by driving cats to vet appointments/picking up donationsI would like more information about Cat Chance's effortsNo, thank you
P E R S O N A L R E F E R E N C E
Reference Name*

First NameLast Name
Relationship*
(e.g., family member, partner, neighbour, employer etc.)
Reference Phone*

Area CodePhone Number
Best Time to Contact
(e.g., evenings, weekends only, 9am-5pm on weekdays, etc.)
Have you ever been convicted of an animal-related crime, such as cruelty to animals, animal theft, or abandonment?*

YesNo
Comments
By clicking the submit button, you are signing off on the following:
- I agree to the Cat Chance Adoption Application process, including personal reference and vet clinic check, home visit (virtual or in-person), and contract arrangements
- I understand there is an adoption fee associated with adoption of a cat or pair of kittens from Cat Chance. I understand this donation will cover their spay/neuter, dewormer, and flea treatments, and ensure the organization is equipped to rescue another community cat
- I understand that it is my responsibility to see and evaluate the cat, for myself, prior to adoption
- I understand there is a one-week trial adoption period, and that if the cat is not well suited to the household, I can return within one week for full refund of the adoption fee and pickup arrangements
- I understand that after the trial adoption period, if I no longer want or can no longer care for my adopted cat, I agree to notify Cat Chance so they can make arrangements for my cat to be surrendered back into their care
- I agree to indemnify Cat Chance and hold harmless against any losses, lawsuits, claims, injury, or damages incurred by me or to any persons or property by my adopted cat, once adoption has been completed
- I understand that Cat Chance will disclose the health and any known behaviour issues of the cat or kittens prior to adoption
- I agree to not separate, by giving away or selling, one of an adopted bonded pair and agree that should Cat Chance learn of this separation, I forfeit all ownership to the cat(s)
- I verify all of the above information is true and accurate, I understand that Cat Chance reserves the right to reject any application with falsified information, and has the right to refuse any applicant
The adoption of a lifelong animal friend should not be impulsive, but rather a carefully thought out decision, which will ensure a loving, lasting relationship. Should it ever become necessary to surrender my adopted cat, I understand that the cat must be returned to Cat Chance.
Signature/Initial
Please sign or place your initial
Date*
YYYY-MMM-DD (i.e., 2021-May-15)
Thank you for completing this application!

Please click SAVE FORM and then SUBMIT so we receive your application.

After this application is received and reviewed, Cat Chance will make a decision about suitability based on the information you have provided - we try to match you with the best cat (or kittens) for your household!

You will hear back from Cat Chance within 5 days of your application if your application was deemed the best fit for the cat (or kittens)!

If you have not heard back from us within that period, please consider applying for another amazing community cat!
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