kims-application.pdf - Teves, Ryan

Please enable JavaScript to view the full PDF

Kim’s Kritters Pet Adoption Application Name/description of the cat(s) you are interested in adopting – 1st choice: ___________________________ 2nd choice: ___________________________ Is this your first cat? YY/N?? /N Why are you interested in adopting this cat? ___________________________________________________________________________________________________ Your name(s):____________________________________________________________________________________________________________________________ Address: __________________________________________________________________ City_______________________ St________ Zip______________________ Hm Ph:_____________________________Cell:_____________________________Email:_______________________________________________________________ List other members in home:______________________________________________________________________ Ages of children:____________________________ Are you at least 18 years old? YY/N?? / N Is everyone in the home aware you are adopting a cat? YY/N?? /N Is anyone in the home allergic to cats? YY/N?? /N Do you own or rent your home? OWN/RENT OWN/RENT?? Complex/Landlord_________________________________________________________ Are pets allowed? YY/N?? /N Does your home have: A pet door? YY/N?? /N A Secured yard? YY/N?? /N (Height of wall/fence) _________________ Will the cat have access to a porch or patio? YY/N?? /N Place of employment:_______________________________________________________________________________ Wk Ph:_____________________________ List pets currently in your home:____________________________________________________________________________________________________________ Are your current pets: Spayed/Neutered? YY/N?? /N Vaccines current? YY/N?? /N If you own dogs, how will you ensure this cat’s safety? __________________________________________________________________________________________ List your Veterinarian/Clinic:_____________________________________ Do we have permission to contact them? YY/N?? /N When was your last Vet Visit?_____________________ Reason for visit_____________________________________________________________________________ List pets you have owned in the last 5 years?___________________________________________________________________________________________________ Where are they now?______________________________________________________________________________________________________________________ Have you taken an animal to a shelter? YY/N?? /N If yes, please explain:_________________________________________________________________________ Have you previously adopted a shelter pet? YY/N?? / N Might you declaw this cat? YY/N?? / N Are you aware of laser declaw surgery? YY/N?? /N Where will the cat live? (Select answer that applies) Click Selecthere for options Options On average, how many hours per day will the cat be outside? _____________ Where will the cat sleep?____________________________________________________ What will happen with this cat if you move? ______________________________________ Go on vacation?________________________________________________ Under what circumstances would you not keep this cat?__________________________________________________________________________________________ What arrangements would you make if you can no longer keep this cat?_____________________________________________________________________________ Would you be agreeable to a scheduled home visit? YY/N?? / N Do we have permission to contact you in the future about this cat? YY/N?? /N I understand that routine care will cost hundreds of dollars and emergency care will can cost thousands of dollars for this cat. YY/N?? /N I understand that this cat will be my responsibility for its entire life, which could even be a 15-20 year commitment? YY/N?? /N IN SIGNING THIS APPLICATION, I AGREE THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. Upon approval, I acknowledge that if any of the information I have provided is found to be untrue, inaccurate or omitted then I am agreeing to a mandatory forfeiture of my legal rights and ownership. (APPLICANT’S SIGNATURE) (Date)