Cat Adoption Application

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YOUR Humane Society SPCA

Cat Adoption Application

Cat Interested In

List the Name or ID # of the cat. If you have no preference, enter "Any Cat".

Today's Date

Name *

First

Last

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address (if different)

Address Line 1

Address Line 2

City

State

Zip Code

Daytime Phone

Cell Phone

Driver's License or ID#

Email *

Gender of Applicant

Male
Female

Date of Birth (Optional)

TERMS OF AGREEMENT

YOUR HSSPCA reserves the right to deny anyone to adopt a cat/kitten without explanation. Even if I am applying for a certain cat, I understand that cats are adopted to the best match and not first come, first served. My application may still be approved but may be better suited to another cat. During the seven (7) day period from the date of adoption, YOUR HSSPCA may refund the adoption fee for a returned animal. In no case will YOUR HSSPCA refund other expenses incurred on behalf of the animal.

Questionnaire: 1.) Is this home your:

Full Time
Seasonal
Vacation

2.) How long have you lived at this address?

If less than 2 years, list previous address.

3.) Will this pet live with you at your current address?

If No, where?

4.) Do you:

Own this home
Rent this home
Live with your parents

Type of home:

House
Apartment
Duplex
Villa
Mobile home w/Lot Rent
Mobile home no Lot Rent
Condominium
Townhouse

5.) List all adults in home:

6.) Ages of all children:

7.) Does anyone in the home have animal allergies?

8.) What are your reasons for adopting a pet?

Companion
Children
Gift
Other

If "Other" please explain:

9.) What are you looking for in a cat?

Age

Gender

Male
Female
No Preference

Color

Personality

10.) This animal will live:

Indoors
Outdoors
Both

11.) Do you have any pets now?

If "Yes", list the types & individual names.

12.) Are these pets' vaccinations current?

Yes
No
Third Choice

If "No", why not?

13.) How many dogs &/or cats have you had in the last 5 years?

What happened to them?

14.) Have you ever had a cat declawed in the past?

15.) Do you plan to declaw your cat?

16.) Please list your current Veterinarian's name or one you have used in the last 5 years.

Animal's name(s) the Vet may have your records filed under:

Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

17.) If you do not have a Veterinarian, provide two (2) non-related references. *

First

Last

Phone Number

Relationship to you:

Reference #2 Name *

First

Last

Phone Number

Relationship to you:

18.) If you should move, what would you do with this pet?

A pet may live many years. Preventative Veterinary care can cost $200 per year and up. This includes booster vaccines and being kept free of intestinal parasites, fleas and ticks. Veterinary care in case of illness or accident can be costly. Some shelter pets have unknown health backgrounds and behaviors. YOUR HSSPCA makes no guarantee as to the age, breed, health or temperament of any animal offered for adoption. YOUR HSSPCA recommends that you take your new pet to a Veterinarian within 7 days.

19.) Are you prepared to give the love your new pet needs and to assume it's financial, training or retraining responsibilities?

20.) Are you familiar with your local Animal Ordinances including licensing and vaccination requirements?

21.) Have you ever been refused adoption of a pet by YOUR HSSPCA or any other organizations?

22.) Have you ever been cited by Animal Services?

23.) Have you ever turned a pet into an animal shelter?

If you answered "Yes" to any questions #21-23, please explain:

24.) Where did you first learn of YOUR Humane Society SPCA??

Electronic signature of Applicant: (must enter FULL NAME below) *

First

Last

Date Signed:

Phone