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Adoption Application
Your Pet History
The Decision to Get a Pet
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Thank you for inquiring about the homeless animals at Katie’s Place.
Please complete this application in full.
Include the history of all pets you’ve had in the last 10 years, whether alive or deceased. Extra forms are available at the end of this form.
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By completing this application, you give us the right to verify the information contained within.
We reserve the right to reject any application for any reason.
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Name
*
Address
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City
*
Postal Code
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Phone 1
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Phone 2
Phone 3
Email
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What year were you born?
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Have you had a cat before?
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Yes
No
How did you hear about Katie's Place?
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Have you read and understood our brochure "The Decision to Get a Pet"?
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yes
no
Have you ever adopted from Katie's Place before?
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yes
no
If yes, what was the animal's name?
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Where are they now?
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Why are you looking to adopt at this time?
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Have you applied for a pet from another shelter or rescue? What was the outcome?
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What kind of pet are you looking for? (Personality, gender, age, hair length, colour, markings, personality traits etc. Please be specific. If you saw a particular cat on our website you are interested in, please mention their name here)
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Are you financially able to provide regular vet care, including spay/neuter, vaccinations, yearly check-ups and emergency care if required?
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yes
no
Please tell us about your home: Who all will be living in the home with this pet? Include Name, Relationship to you, age, and any allergies
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Is everyone living in the home in agreement about adopting a pet at this time?
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What are the ages of children frequently visiting the home?
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Do you currently live in a
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House
Apartment
Townhouse
Basement Suite
Mobile Home
Other (please specify below)
Other housing
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Square Footage
*
Where you live, do you...?
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Rent
Own
Lease
Landlord's Name
*
Landlord's Phone Number
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Are pets allowed?
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yes
no
Please tell us about how this pet will live: Who will be the main care giver for this pet?
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Will this pet be...?
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Indoor Only
Outdoor only
Indoor & Outdoor
Where will this pet spend its daytime hours? (Be specific, ie basement, barn, deck, yard, porch, laundry room, bedroom, kitchen, entire house etc.)
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Where will this pet spend its evening hours? (Be specific, ie basement, barn, deck, yard, porch, laundry room, bedroom, kitchen, entire house etc.)
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Where will this pet spend its nighttime hours? (Be specific, ie basement, barn, deck, yard, porch, laundry room, bedroom, kitchen, entire house etc.)
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Do you have a dog or cat door or plans to install one or more?
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yes
no
Do you work...?
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full time
part time
retired
Do you work..?
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in the home
away from home
not applicable
What will happen to the pet if you have to move?
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Under what circumstances would you NOT be able to keep this pet?
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What would happen to this pet if something happened to you?
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Please describe how you will feed this pet? (Brand, food type, frequency etc.)
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Have you ever been forced to give an animal away for any reason?
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yes
no
If yes, please explain
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What will happen if this new pet does not get along with an existing pet in the home?
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What is your monthly budget for a single cat for food?
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What is your monthly budget for a single cat for litter?
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What is your monthly budget for a single cat for vet care?
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Do you have a regular veterinarian?
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yes
no
Veterinarian's Name
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Veterinarian's Phone Number
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What is your philosophy on vet care?
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What qualities do you look for in a vet?
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What is your financial limit for vet care?
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Have you ever not conducted tests or care recommended by your vet due to cost?
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How do you feel about pet insurance?
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What treatments have your pets (past or present) ever received? Please check all that apply.
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Annual Check Ups
Antibiotics
Bloodwork
Cancer Treatment
Dental Work/Cleaning
Diabetes Care
Euthanasia
Flea/Worm
Spay/Neuter
Specialist
Sub-Cu Fluids
Tattoo/ Microchip
Thyroid
Vaccines
X-Rays
none of the above
Pet History 1 - Please enter the name of your previous (or current) pet
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Species [eg cat,dog,rat,fish]
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Breed [eg Siamese, short-haired tabby, Chihuahua]
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Date of birth
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Spayed/Neutered?
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yes
no
not sure, not applicable
Where and when did you get him/her?
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Where is he/she now?
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If deceased, please share the date & circumstances
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What is he/she like (describe their personality)?
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What vet did he/she see?
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Is there anything else you would like us to know about him/her?
*
Don't forget to include your complete pet history for the last 10 years.
Submit
After submitting, click here to continue your pet history <<<
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Sat & Sun: 12 noon - 2:00pm
_
OPENING HOURS
Saturday & Sundays 12:00 noon - 2:00pm
10255 Jackson Road, Maple Ridge, BC
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