StreetCats, Inc.

Adoption Application

This questionnaire is not intended to invade your privacy, but to ensure that the right pet goes to the right home.  All adoptions are made at the discretion of StreetCats, Inc.  You will hear from us within 7 days, or please assume your application was not selected.

 

Date: _______________

First Choice-StreetCat Name: ____________________________________________________________ 

Description: __________________________________________________________________________

            If the cat you have chosen is unavailable, do you have a second choice? __________

Second Choice-StreetCat Name: _________________________________________________________

Description: __________________________________________________________________________



Your Name: __________________________________________________________________________

Address: ________________________________        City: __________________       Zip: _____________

Phone/Home: ____________________________        Cell: _____________________________________

Place of Employment: _________________________________ Work Phone: _____________________

Email Address: _______________________________________________________________________

 

 


Circle one:  Cat will be    Inside Only     Outside Only    Inside/Outside

Are you aware that the cost to feed, vaccinate, and provide medical care of this animal can run into hundreds of dollars per year? ____________

How many adults live in your home? _________   Children? (Ages) _______________________________

Is anyone in your family allergic to animals? _____________         Explain: _________________________

Do you live in a house _______ or apartment ________?

Does your landlord/apartment complex allow pets? _________

May we contact your landlord/apt. complex? __________        Phone:  ____________________________

When you travel, who will care for your pet? __________________

 

 


Please list any pets that you “currently” have:

Name

Breed/Species

Age

Spayed/Neutered

 

 

 

Yes / No

 

 

 

Yes / No

 

 

 

Yes / No

 

 

 

Yes / No

 

Are all of your pets current on vaccinations? ________________

May we contact your vet?  Name: ____________________________          Phone: ___________________

If you have no current vet, please list the name and number of a previous veterinarian that could give you a reference: _________________________________________________________________________

Please list any pets (other than those listed previously) that you have had in the last 5 years:

Name

Species/Breed

Spayed / Neutered

Reason for no longer having pet

Age when
pet died

 

 

Yes / No

 

 

 

 

Yes / No

 

 

 

 

Yes / No

 

 

 

 

Yes / No

 

 

How do you discipline your pets? _________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

Why do you want a cat? ________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

References

Name: ___________________________________________________     Phone: ___________________

Name (not a relative) _______________________________________         Phone: ___________________

I certify that the above is true and that any false information may result in nullifying the adoption.  I give StreetCats, Inc. permission to contact any veterinarians listed to obtain current and past medical records and pet care information.  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 cat.

Applicant Signature: ___________________________________________________________________

 


Interviewed by: _____________________________________________    Date: _____________________

Reference Check by: ________________________________________    Date: _____________________

Remarks: ___________________________________________________________________________

Approved: __________      Rejected: __________

Applicant notified by: ________________________________________       Date: _____________________

Interviewer Comments:

 

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