Please do not submit applications via moble phoneas we will not receive it. Thank you!
Today’s Date: ...
Cat Choice #1:
Cat Choice #2 (optional):
Cat Choice #3 (optional):
Cat Choice #4 (optional):
Please list any preferences (age, sex, breed, color, personality)
Adoption Fee Agreement Yes No
Please print identification information clearly, especially email address:
First Name:
Last Name:
Maiden Name (if applicable)
Address:
City:
State:
Zip Code:
Email: *
Place of Employment:
Since (mo/yr):
Home Phone:
Work Phone:
Would you like to receive our newsletter? Yes No
How did you hear about our rescue?
For whom are you adopting the cat?
Choose One: Self Gift Other Family Member
Why do you want to adopt a cat?
Who will be the main caregiver of the cat?
What do you think are the most important responsibilities in owning a cat?
Have you submitted an application with another organization for a cat at this time? Yes No
Have you ever had an application declined for adoption of an animal from an animal welfare group/animal control facility? Yes No *
If Yes, please explain:
Your Age:
Do you live with: Spouse/Partner Roommates Parents Alone
How many people live in your home?
Are there any children in the household, including “part-time” children? Yes No
If yes, what are their ages?
How many adults (21 and older) in your household?
How far would you be willing to travel to pick up a cat?
If needed, would you pay for or assist with shipping expenses?
Does any member of the family have any allergies to animals?
Describe the kinds of personal situations where you might have to return your adopted dat, i.e., job loss, children, move, marital change, etc.:
What would you do if you could not keep the animal? Please be specific:
If you move, will you take the cat?
Do you or anyone smoke in the house?
Are all parties involved on board and willing to help with the care of new addition? Yes No *
Cat's living situation (check all that apply) Cat will be house pet, living inside with family Cat will in basement or garage Cat will live outdoors
How many hours a day will the cat be home alone?
When home alone, the cat will be: (check all that apply) In a crate Wire cage Cat pen inside Outdoor Indoor
Cat will be loose:
Cat will be: Indoor Outdoor *
Other - please specify:
Where will the cat sleep at night?
Home Setting: Urban Suburban Rural
Yard size: Small Medium Large Acreage
Your home is: House Apartment
Do you own the property? Yes No
How long have you lived at this address? If less than 1 year, please also list prior address.
If you are renting, please provide Landlord's name and phone number for verification:
If your land lord allows cats, is there a weight/size/breed restriction? Yes No Don't know
If “yes”, what is their restriction?
Do you have other Pets living with you now? Yes No
If Yes, please list in box on right including pet's name:
Are all your windows screened? Yes No
Are you going to declaw? Yes No
Is your cat indoor/outdoor or both? Indoor Outdoor Both
Is the cat going to be used for a mouser? Yes No
Name
Type
Age
Sex
Was the pet Spayed or Neutered?
Primarily Indoor or Outdoor?
What year did you get the animal?
How did you acquire the animal?
Year deceased (or last year you had pet)?
Cause of death, or where pet is now (detail)
Name of vet you will use for your new pet:
What kind of veterinary care do you plan to provide?
Have you considered the extra expenses that will come with having a cat including vet care, food, supplies and equipment, toys, training and boarding? Please explain:
If you are applying for a kitten/cat who is not housetrained, how will you housetrain the cat?
If a behavioral problem arises, what steps will you take to work on it?
How would you discipline the cat?
What will you do if the cat gets into trouble by ruining something you value?
Are you familiar with heartworm disease? Yes No
If yes, how would you prevent it?
List the types of behavior problems you consider NOT acceptable:
At what point would you consider humane-killing (euthanasia), should your cat become ill?
Experience: Please relate any prior experience you have had with cats:
By checking YES you agree to absolve Pibbles & More Animal Rescue and all of its representatives from any liability in reference to a pup featured in this web site. Yes No
By checking YES you agree that the cat is to be kept as a house pet. It shall not be sold for medical or experimental purpose, and it shall not be used for breeding. Yes No
By checking YES you agree that if you are chosen to adopt the cat, you will review and agree to an adoption contract, which is wholly in the cat’s best interests. Yes No
By checking YES you agree that if you ever need to relinquish the animal during its life, you will contact Pibbles & More Animal Rescue for its surrender. Yes No
By checking YES, we have permission to contact these references Yes No
By checking YES, you agree to provide a copy driver’s license with operator’s license number visible or photo ID with ID number visible Yes No
By checking YES, upon approval, do you agree to provide the license plate # of your vehicle Yes No
References Please supply the name and phone number of your current veterinarian, or the one who saw your previous pet(s), with their title identification. Veterinarian’s Name, address and phone number: "Please make sure that YOUR name and phone number are on the vet's records/files (contact them prior to submitting this application to us, if need be). Otherwise they will NOT be able to locate your records and give us a reference for you, and we will not be able to process your application."
1st Reference
2nd Reference
3rd Reference
Please tell me why you are interested in adopting a cat and a little about your lifestyle:
I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand that the Pibbles & More Animal Rescue reserves the right to annul the adoption and reclaim the animal. If the application passes this review, I agree to a home and yard visit on a mutually agreed date by a Pibbles & More Animal Rescue volunteer or a courtesy visit through another reputable rescue before an adoption decision is made.
In addition, I understand the adoption decision is dependent on many factors, including but not limited to the compatibility of the family and home to the individual animal, and other applications received on this animal. I understand it is the organization's prerogative to decide which home is most appropriate and that their decision is final.
Signature(s) *
Date *
Printed Full Name(s) *
Thank You for filling out our Adoption Application!
