Cat / Kitten Adoption Application All applications are subject to review by the Adoption Committee. Completion of this application does NOT guarantee an adoption. All items marked with an asterisk must be provided. Please enter NA to items that may not pertain to your situation. Step 1 of 4 25% Pet's Name*Name* First Last Applicant's Date of Birth* Date Format: MM slash DD slash YYYY mm/dd/yyyyAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Phone*Second PhoneEmail* Are you adopting for:*YourselfYou and your familyChild/renBusinessOtherOtherHow many people live in your home?*Number of children?*Children's ages?*Why do you want to adopt?What is your living situation?* House Apartment Condo Mobile home Other b.* Own Rent Live with family member/roommate/spouse On average, how many hours a day will the cat be alone?*Cat’s/kitten's primary living quarters will be:*InsideOutsideIndoors & OutdoorsDo you plan to declaw? Yes No Unsure Please describe what you are looking for in your new cat*If you currently have animals or had them in the past, which veterinary clinic(s) do you use?*According to the ASPCA, the average annual cost of owning a cat is $454. Are you prepared to make this commitment?* Yes No Unsure Please complete the following for all pets you currently have:First animal's name / sex?First animal's type/breed?First animal spayed / neutered?YesNoHow long have they been with you?First pet's current age?First animal's health / behavior problems?Second animal's name / sex?Second animal's type/breed?Second animal spayed / neutered?YesNoHow long have they been with you?Second animal's current age?Second animal's health / behavior problems?Third animal's name / sex?Third animal's type/breed?Third animal spayed / neutered?YesNoHow long have they been with you?Third animal's current age?Third animal's health / behavior problems?Fourth animal's name / sex?Fourth animal's type/breed?Fourth animal spayed / neutered?YesNoHow long have they been with you?Fourth animal's current age?Fourth animal's health / behavior problems?Fifth animal's name / sex?Fifth animal's type/ breed?Fifth Animal spayed / neutered?YesNoHow long have they been with you?Fifth animal's current age?Fifth animal's health / behavior problems? Please describe your PREVIOUS pets (include pet names, breeds, spayed/neutered, dates owned, etc.)*Please give a personal reference. Name, relationship, and Phone#*Although I understand that every animal adopted has been inspected and its history reviewed, I appreciate that you can make no warranty in regard to the pet, and that you can give me only such information as you have received with regard to the pet. I further understand that any donation I have given to the Animal Care Society is a donation towards its work in caring for the pets.* I Agree to the above terms and conditions I CANNOT agree to the above terms and conditions Certification Although I understand that every animal adopted has been inspected and its history reviewed, I appreciate that you can make no warranty in regard to the pet and that you can give me only such information as you have received with regard to the pet. If, for any reason, I am not able to care for my adopted pet, I will contact the Animal Care Society for acceptance into the Center and readoption. The Society will determine whether or not the pet can be accepted for readoption, or for including the pet in its referral for adoption records. If the Animal Care Society demands the pet’s return for any reason, I agree to promptly return the pet to the Center. I shall be personally responsible for the humane care and control of the pet and I agree that your agent shall be allowed to see the pet at any reasonable time. I further understand that any donation I have given to the Animal Care Society is a donation towards its work in caring for pets. Applicant Signature ______________________________ Date ______________________ ACS Witness _____________________________________
