Adoption Form - Caring Hearts Cat Rescue and Sanctuary

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Adoption Form

Name*
First Last
Address*
Street Address Address Line 2 City Province Postal Code
Home Number*
Cell Number
Work Number
Home E-mail*
Enter Email Confirm Email
Work E-mail
Enter Email Confirm Email
Employer
Occupation
1. What type of cat are you interested in?*
- Male
- Female
- Kitten (under 5 months)
- Adult
- Long haired
- Short haired
- No preference
Personality type
Colour
If there is a specific cat from our website you are interested in, please provide his/her name here:
2. How many people currently reside in your household?*
3. Are there any children in your household?*
- Yes
- No
List their ages:
4. For whom are you adopting the cat?*
- For yourself
- As a gift for someone else
5. Does any member of your family have any allergies to animals?*
- Yes
- No
If yes, please explain
6. Who will be responsible for the cat's care?*
7. Where do you live?*
- Apartment
- Condo
- Farm
- Mobile Home
- Townhouse
- Home
8. Do you rent or own your residence?*
- Own
- Rent
If you rent, what is your landlord's name?
What is your landlord's phone number?
9. Are pets allowed where you live?*
- Yes
- No
- Not sure
10. Where will the cat be kept?*
- indoors only
- Outdoors only
- Both in and out
11. If outdoors, will the cat be
- attended
- unattended
- collar and tags
12. Will anyone be home during the day?*
- Yes
- No
13. How many hours will the cat be left unattended?*
14. When no one is home, where will the cat be kept?*
15. If you move, what will you do with the cat?*
16. How far from the road/traffic is your home/farm located?*
17. Is the volume of traffic:*
- light
- moderate
- heavy
18. Have you ever had a pet before?*
- Yes
- No
19. Describe those pets you still care for or that are living in your household
Name
Breed
Age
Neutered
- Yes
- No
They are kept where?
Time in your care?
20. Describe those pets you no longer care for:
Name
Breed
Age
Neutered
- Yes
- No
Where were they kept?
Time in your care
Reason they are no longer with you
21. Are your pets current on their vaccinations?
- Yes
- No
22. Please provide the name of your veterinarian
Please provide the phone number of your veterinarian
24. Are you financially able and willing to provide annual check ups, vaccinations and ANY medical care necessary?*
- Yes
- No
25. Do you have a dog?*
- Yes
- No
If yes, is he/she permitted to run loose?
- Yes
- No
26. What precautions would you take to properly introduce a new cat into your home if you have other animals (a dog, bird, rabbit, another cat, etc.)?
27. What will you do if your new cat does not get along with your present pets?
28. Are you planning on declawing?*
- Yes
- No
- Not sure
29. Have you ever adopted an animal from a rescue/animal control agency?*
- Yes
- No
30. Have you ever had an application rejected for adoption of an animal from a rescue/animal control facility?*
- Yes
- No
If yes, please explain
31. Why do you want to adopt a cat?*
32. If a disciplinary or behaviour problem arises, what steps will you take to work on it?*
33. Are you familiar with your local animal control laws?*
- Yes
- No
34. Are you willing to sign legal pet adoption papers?*
- Yes
- No
35. Do you agree to permit a visit to your home/farm by appointment?*
- Yes
- No
Please list two references not living with you, including phone numbers below:
Declaration
- By clicking this box, I/we acknowledge that all information on this form is true and correct. I/we understand that any misrepresentation of fact may result in Caring Heart Cat Rescue & Sanctuary refusing adoption privileges to me/us. If my/our request for adoption is approved and later Caring Hearts Cat Rescue & Sanctuary discovers the above information is not true or correct, Caring Hearts Cat Rescue & Sanctuary reserves the right to remove the adopted cat from my home/farm.
Name
Date of Declaration
Date Format: MM slash DD slash YYYY
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

News & Events

PetSmart National Adoption Weekend Feb 28 – Mar 1

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