Adoption Application v3 page

Name *

Address *

City *

Postal Code *

Home Phone

Work Phone

Cell Phone

Email *

What year were you born? *

Have you had a cat before? *

Yes
No

How did you hear about Katie's Place?

Have you read and understood our brochure "The Decision to Get a Pet"? *

yes
no

Have you ever adopted from Katie's Place before? *

yes
no

If yes, what was the animal's name?

Where are they now?

Why are you looking to adopt at this time?

Have you applied for a pet from another shelter or rescue? What was the outcome?

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)

Are you financially able to provide regular vet care, including spay/neuter, vaccinations, yearly check-ups and emergency care if required?

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

Is everyone living in the home in agreement about adopting a pet at this time?

What are the ages of children frequently visiting the home?

Do you currently live in a

Other housing

Square Footage

Where you live, do you...?

Rent
Own
Lease

Landlord's Name

Landlord's Phone Number

Are pets allowed?

yes
no

Please tell us about how this pet will live: Who will be the main care giver for this pet?

Will this pet be...?

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.)

Where will this pet spend its evening hours? (Be specific, ie basement, barn, deck, yard, porch, laundry room, bedroom, kitchen, entire house etc.)

Where will this pet spend its nighttime hours? (Be specific, ie basement, barn, deck, yard, porch, laundry room, bedroom, kitchen, entire house etc.)

Do you have a dog or cat door or plans to install one or more?

yes
no

Do you work...?

full time
part time
retired

Do you work..?

in the home
away from home
not applicable

What will happen to the pet if you have to move?

Under what circumstances would you NOT be able to keep this pet?

What would happen to this pet if something happened to you?

Please describe how you will feed this pet? (Brand, food type, frequency etc.)

Have you ever been forced to give an animal away for any reason?

yes
no

If yes, please explain

What will happen if this new pet does not get along with an existing pet in the home?

What is your monthly budget for a single cat for food?

What is your monthly budget for a single cat for litter?

What is your monthly budget for a single cat for vet care?

Do you have a regular veterinarian?

yes
no

Veterinarian's Name

Veterinarian's Phone Number

What is your philosophy on vet care?

What qualities do you look for in a vet?

What is your financial limit for vet care?

Have you ever not conducted tests or care recommended by your vet due to cost?

How do you feel about pet insurance?

What treatments have your pets (past or present) ever received? Please check all that apply.

Pet History 1 - Please enter the name of your previous (or current) pet

Species [eg cat,dog,rat,fish]

Breed [eg Siamese, short-haired tabby, Chihuahua]

Date of birth

Spayed/Neutered?

yes
no
not sure, not applicable

Where and when did you get him/her?

Where is he/she now?

If deceased, please share the date & circumstances

What is he/she like (describe their personality)?

What vet did he/she see?

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.

Thank you for inquiring about the homeless animals at Katie’s Place.

Please complete this application in full.

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.

Include the history of all pets you’ve had in the last 10 years, whether alive or deceased.

After submitting, click here to continue your pet history <<<

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