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Cat Adoption Application
Submitted by
Anonymous (not verified)
on Tue, 04/01/2014 - 12:37
Please select type of application:
*
Foster
Adopt
Foster-to-Adopt
Pet Name
*
Located pet at/on
- None -
LovingArmsPetPlacement.com
Copperfield PetSmart
Name of Applicant
*
Name of Co-Applicant
Applicant Address
*
City
*
State
*
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
*
Primary Phone
*
Secondary Phone
Email address
*
Best time of day to contact
*
Applicant Occupation & Work Schedule
*
Are you aware that routine costs to maintain a pet average $500 to $800 dollars a year?
*
- Select -
Yes
No
Please list all members of the household (excluding pets), first name and age
Please list all pets in household
Are all household pets spayed/neutered?
*
- Select -
N/A
Yes
No
If "no," please indicate status of pet
If you have a dog, do you have a dog door?
- None -
N/A
Yes
No
Other than children living in the household, will your pet come in contact with other children under the age of 5?
*
- Select -
N/A
Yes
No
Do any elderly or physically challenged people live with you or visit frequently?
*
- Select -
N/A
Yes
No
Do you own or rent your home?
*
- Select -
Own
Rent
If you rent, do you have your landlord's permission to have a pet?
- None -
N/A
Yes
No
May we contact your landlord to verify permission?
- None -
N/A
Yes
No
Name of your landlord
Landlord's Phone Number
Do you have a fenced yard?
*
- Select -
N/A
Yes
No
Describe fence height and condition:
Will this be your first pet?
*
- Select -
Yes
No
Have you ever bred a pet?
*
- Select -
Yes
No
Have you ever sold a pet?
*
- Select -
Yes
No
Have you ever given a pet away?
*
- Select -
Yes
No
Have you ever surrendered a pet to a shelter?
*
- Select -
Yes
No
If you answered yes to any of the preceding questions, please explain the circumstances:
Do all family members want a pet?
*
- Select -
Don't Know
Yes
No
Please tell us the reason you want a pet
*
Why do you think you would be a good caregiver to a pet?
*
What age pet fits your lifestyle and expectations?
*
Are you aware that some pets are very active?
*
- Select -
Yes
No
Do you have time and are physically able to give active pets adequate exercise?
*
- Select -
Yes
No
Is anyone home during the day?
*
- Select -
Yes
No
It Varies
How long will the pet normally be left alone during the day?
*
Are you aware that all pets shed year around?
*
- Select -
Yes
No
Is anyone in your home prone to allergies or may be adversely affected by a pet?
*
- Select -
Yes
No
Pet will be primarily kept
Indoors
Outdoors
If you become sick or hospitalized, what provisions can you make for your pet?
What brand of pet food do you currently use?
What will happen to the pet if you get married, divorced or have children?
If you move, what will you do with your pet?
Where will your pet sleep at night?
Will the litter box be kept inside?
*
- Select -
Yes
No
Please check all that apply to pet:
Have the run of the house
Be blocked off parts of the house
Will the cat be declawed?
*
- Select -
Yes
No
Will the cat be allowed outside?
*
- Select -
Yes
No
Are you familiar with your local, county and state laws?
*
- Select -
Yes
No
May we visit your home prior to application approval?
*
- Select -
Yes
No
Indicate best time/day for home visit:
May we contact your veterinarian?
*
- Select -
Yes
No
Veterinarian Contact Information
*
(Clinic Name, Address, Phone Number)
How would you discipline your pet?
*
Have you ever had a pet with behavior issues?
Check all viable reasons to give a pet up:
Moving
Pet has fleas
Not using litter box
Shy/Not friendly
Vet bills too expensive
Got too big
Having a baby
Clawing/biting
How many years will you keep your pet?
Who is primarily responsible for pet?
*
How would you try to find a lost pet?
*
How would you deal with destructive behavior by your pet?
*
How would you know if your pet became ill? What type of symptoms would you expect?
*
Answers are expected to be complete and truthful, as they will enable us to better comply with your requests and requirements. Failure to provide accurate information can result in revocation of the adoption at any time by Loving Arms Pet Placement. By completing this form the undersigned expressly give permission to Loving Arms Pet Placement to verify information contained in this application, and further release Loving Arms Pet Placement from any and all liability associated with this application or the adoption process.
Agree or Disagree?
*
- Select -
Agree
Disagree
I/We attest that the Terms and Conditions of Adoption, as stated above, have been read in full by Me/Us and I/We understand that these terms constitute a part of the adoption agreement between Me/Us and Loving Arms Pet Placement and will be enforced.
Agree or Disagree?
*
- Select -
Agree
Disagree
I/We attest that information provided on this application is true and accurate to the best of My/Our knowledge. I/We understand that completion and submission of this application does not guarantee adoption of a pet. If application is submitted electronically, I/We further attest that no changes have been made to the content of this document and understand that my approval by signature is assumed and agree to transmit a signed original or facsimile prior to any decision by Loving Arms Pet Placement on my Adoption application.
Agree or Disagree?
*
- Select -
Agree
Disagree
Our volunteers may take up to two weeks to complete the application process; are you willing to wait?
*
- Select -
Yes
No
Loving Arms Pet Placement will require a $250 donation if application is approved; are you willing to pay this amount?
*
- Select -
Yes
No
Comments or Suggestions
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