Cat Adoption Form Cat Adoption Form Please fill out the following information if you are interested in adopting a cat. Date Submitted* Month Day Year How did you hear about us? Name of Cat or description* For example: Hazel or kittenName of the cat's Temporary Home (if known) Have you been in contact with anyone from our organization? If so, please type their name hereApplicant Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County of Residence* Phone*Format as 555-555-5555Email Address Please enter an email that you check frequentlyHow would you prefer we contact you?* Email Phone Call Text Message Home InformationDo you own your home?* Yes No Landowner's Name* Landowner's Phone*Do you plan to move in the near future?* Yes No Number of Adults in your Household:*Number of Children in your Household*Do you Currently Have Pets?* Yes No If Yes, How Many?Dogs:Cats:Other, list type and how many:Are they spayed/neutered?* Yes No If your current pets are not spayed/neutered, Why not?Are they up to date on all vaccinations?* Yes No If your current pets are not up to date on vaccinations, why not?Your Vet's Name:* Your Vet's Phone Number:List any pets that you have had within the last three years and no longer have: (Type & Reason)Adopted Cat EnvironmentDo you plan to declaw the cat?* Yes No Unsure & need information Will the cat be allowed outside?* Yes No If Yes, how will you make sure he/she is safe from other animals, weather, and traffic?*Where will the cat be spending most of his/her time during the day and night?*How will the cat be cared for when you go on vacation?*How will you train the cat to stay off counters/tabletops?*What will you do if the cat doesn't use the litter box?*Additional CommentsAdopter Agrees All information provided is accurate to the best of his/her knowledge. He/she is 18 years or older. To provide shelter, fresh water, proper food and adequate companionship at all times. The cat will be kept indoors. To provide adequate vet care such as annual veterinary examination, vaccinations, medications as directed, and flea preventive. To arrange with Safe Home Rescue for sterilization procedure if the cat is too young to sterilize at the time of adoption. To follow positive reinforcement training methods. To notify Safe Home Rescue if for any reason adopter is unable to keep this cat and Safe Home Rescue will find an appropriate home. A refund of the adoption fee will be provided within 30 days of adoption. Transfer of ownership of this pet is strictly prohibited without authorization of Safe Home Rescue. The cat will not be euthanized in a non-emergency situation without notifying Safe Home Rescue and giving 3 days to respond. To receive information from 24PetWatch regarding your cat's microchip registration. RELEASE OF LIABILITY AND INDEMNIFICATION Adopter agrees to be responsible for this animal and will hold harmless Safe Home Rescue from any claims of liability for the conduct of the pet on or after the date of the adoption.Checking this box below indicates your acceptance to the terms stated above.* I Agree
