SCC - Cat Adoption Form

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CAT ADOPTION FORM

Please READ - Important Note:

To move from one box to the next, please either click on the next box or use the "Tab" key to move through this form. Do not use the "Enter" key, as this will submit the form before it is complete.

ABOUT THE APPLICANT
(Must be 18 years of age or older)

Name:
E-mail Address:
(Please note that we primarily communicate by e-mail)
Home Phone:	(include area code)
Work Phone:	(include area code)
Cell Phone:	(include area code)
Address:
City:
State:
Zip Code:

PERSONAL INFORMATION

Why do you want a cat?

If you have children in the home, what are their ages?

What has your experience with pets been like in the past?
Descibe in detail:

Is anyone in the house alergic to animals?

YesNo

Does your entire household agree to the adoption?

YesNo

WHAT YOU'RE LOOKING FOR

Breed Wanted:
Age Desired: (check all that apply)	Puppy (Weaned - 6 mo.) Young (6 mo. - 2 yrs) Adult (2 yrs +)
Sex:	Male Female Either
Special Requests: (training, color, etc...)
If cat is not altered, will it be done within 10 working days? YesNo
How long are you willing to give your new cat to adjust to it's new home?
Do you plan to declaw the cat/kitten you adopt? YesNo

Are you willing to give a home to an elderly cat, one with medical issues, or one that needs immediate training/obedience classes?
(Please be specific, because we have some wonderful pets needing new homes due to these very issues)

A cat with medical issues?	Yes No
An older cat?	Yes No
Cat with training issues?	Yes No

CURRENT LIVING SITUATION

Cat to live:	Mostly Indoor Only Indoors Mostly Outdoor Equal time In and Out
Where will cat sleep: (be specific)
How many hours will the cat be home alone during the day, on average?
Do you own any other pets?	Yes No
Number of cats or dogs:	Cats: Dogs:
Are all dogs/cats altered?	Yes No
If you have an unaltered pet, give your reason for doing so:
Are current pets up to date on vaccination?	Yes No
Do all current pets in your home have identification (microchipped, licensed, tags) in case they are lost?	Yes No
Describe any other pets and livestock:
Current Vet: (name and phone number)
If no current vet, who you plan to use for your new pet? (name and phone number)
How long have you owned your current pets?
What has happened to pets owned in the past? (be specific)
Do you rent or own?	Rent Apartment Rent House Own Home
Landlord's name and phone number, if applicable:
How long do you plan to live here?
Is your home located on:	City Lot Country Lot Acreage
Traffic on your street is:	Light Medium Heavy
Where will you confine a cat while it gets used to its new home?

REFERENCES

Please provide information for three references (other than your vet or landlord; please do not list immediate family) who know you as a pet owner or can vouch for your overall responsibility

Reference #1
Name:
Phone #:
E-Mail:
Relationship:

Reference #2
Name:
Phone #:
E-Mail:
Relationship:

Reference #3
Name:
Phone #:
E-Mail:
Relationship:

Have you spoken to an SCC adoption counselor already? If so, please list their name:

Please list which cat(s) you are interested in and why they interest you:

By submitting this application, you agree that the addition of a family pet is an important decision. You have thought through possible changes that may occur in your life, and feel you would still be willing and able to care for this pet should they occur. You agree that if for any reason you can no longer care for this pet, you will without fail contact Second Chance Companions.

SCC makes random visits to adoptive homes to check on the well-being of the pet, and reserves the right to revoke the adoption if we find specific conditions are not being met. Terms will vary from pet to pet, and will be outlined on the adoption contract.

I HAVE READ AND AGREE WITH THE ABOVE STATEMENT

YESNO

Upon receipt of this application, an Adoption Counselor will check your references, including your current vet, and then get back to you about scheduling a home visit. They will also tell you how to get in touch with the current caretakers of dogs who would be a good match for your home. Your application will be processed as quickly as possible, but please understand we are staffed by volunteers and it may take a few days.

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