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Cat Adoption Application

Adoption: Cat

Adoption form information fields

1Applicant

2Family

3Home

4Care

5Preferences

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Default: Cat Adopter Status
First Name*
Last Name*
Age Range*
eMail Address*
eMail Address Confirm eMail Address
Street Address*
Suite | Apt or Unit Number
City*
State/Province*
ZIP*
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Country*
Home Phone Number
Work Phone Number
Cell Phone Number*
- Preferred Method of Contact
Employment & Schooling
- Are You Employed?*
  - Yes
  - No
  - Retired
- Full or Part Time?*
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  Name of Employer
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  How Long Employed There?
- Are You in School?*
  - Yes
  - No
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  Full or Part Time?*
- Previous Experience With Cats*
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  How Did You Hear About Us?*
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  What Is Your Friend's Name?*
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  Which Shelter?*
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  Which Rescue?*
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  Please Describe*

Below are three areas for information on other members of your family. Please include all other adults, children and pets living in your home by clicking on the designated button.
Adults
Are There Other Adults In The Home?*
- Yes
- No
How Many?*
Adult 1
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Previous Experience With Cats*
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Please Describe*
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Phone Number*
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eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Full or Part Time?*
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Name of Employer*
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How Long Employed There?*
Are They in School?*
- Yes
- No
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Full or Part Time?*
Adult 2
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Previous Experience with Cats*
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Please Describe*
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Phone Number*
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eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Full or Part Time?*
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Name of Employer*
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How Long Employed There?*
Are They in School?*
- Yes
- No
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Full or Part Time?*
Adult 3
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Previous Experience with Cats*
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Please Describe*
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Phone Number*
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eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Full or Part Time?*
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Name of Employer*
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How Long Employed There?*
Are They in School?*
- Yes
- No
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Full or Part Time?*
Adult 4
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Previous Experience with Cats*
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Please Describe*
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Phone Number*
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eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Full or Part Time?*
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Name of Employer*
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How Long Employed There?*
Are They in School?*
- Yes
- No
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Full or Part Time?*
Children
Are There Children In The Home?*
- Yes
- No
How Many?*
Child 1
Name*
Age*
Gender*
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Previous Experience With Cats*
Child 2
Name*
Age*
Gender*
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Previous Experience With Cats*
Child 3
Name*
Age*
Gender*
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Previous Experience With Cats*
Child 4
Name*
Age*
Gender*
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Previous Experience With Cats*
Cats
Do You Now Or Have You Ever Had a Cat?*
- Yes
- No
Have You Ever Taken Care Of a Cat Before (ie Cat Sitter ,etc) or Have Any Other Cat Experience?*
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Please Describe*
How Many?*
Cat 1
Cat's Name*
Where Did You Get The Cat?*
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Please Explain*
Is the Cat Still Living With You?*
- Yes
- No
Why Not?*
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Which Years Owned?*
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How Long Did You Own Him/Her?*
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Why Was Cat Euthanized?*
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Please Describe the Situation*
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Please Describe the Situation*
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Please Describe*
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Sleeping Quarters*
Where Does Cat Live?*
Breed*
Age Range*
Gender*
Status*
Please Explain Why Not*
Socialibility*
Up To Date On All Vaccines?*
- Yes
- No
Has Cat Been Declawed?*
- Yes
- No
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Did Your Vet Do The Declaw?*
- Yes
- No
Is There Any Additional Information You Would Like to Add?
Cat 2
Cat's Name*
Where Did You Get The Cat?*
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Please Explain*
Is the Cat Still Living With You?*
- Yes
- No
Why Not?*
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Which Years Owned?*
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How Long Did You Own Him/Her?*
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Why Was Cat Euthanized?*
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Please Describe the Situation*
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Please Describe*
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Sleeping Quarters*
Where Does Cat Live?*
Breed*
Gender*
Age Range*
Status*
Please Explain Why Not*
Socialibility*
Up To Date On All Vaccines?*
- Yes
- No
Has Cat Been Declawed?*
- Yes
- No
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Did Your Vet Do The Declaw?*
- Yes
- No
Is There Any Additional Information You Would Like to Add?
Cat 3
Cat's Name*
Where Did You Get The Cat?*
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Please Explain*
Is the Cat Still Living With You?*
- Yes
- No
Why Not?*
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Which Years Owned?*
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How Long Did You Own Him/Her?*
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Why Was Cat Euthanized?*
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Please Describe the Situation*
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Please Describe*
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Sleeping Quarters*
Where Does Cat Live?*
Breed*
Age Range*
Gender*
Status*
Please Explain Why Not*
Socialibility*
Up To Date On All Vaccines?*
- Yes
- No
Has Cat Been Declawed?*
- Yes
- No
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Did Your Vet Do The Declaw?*
- Yes
- No
Is There Any Additional Information You Would Like to Add?
Cat 4
Cat's Name*
Where Did You Get The Cat?*
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Please Explain*
Is the Cat Still Living With You?*
- Yes
- No
Why Not?*
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Which Years Owned?*
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How Long Did You Own Him/Her?*
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Why Was Cat Euthanized?*
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Please Describe the Situation*
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Please Describe*
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Sleeping Quarters*
Where Does Cat Live?*
Breed*
Age Range*
Gender*
Status*
Please Explain Why Not*
Socialibility*
Up To Date On All Vaccines?*
- Yes
- No
Has Cat Been Declawed?*
- Yes
- No
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Did Your Vet Do The Declaw?*
- Yes
- No
Is There Any Additional Information You Would Like to Add?
Other Animals
Are There Other Animals In The Home?*
- Yes
- No
How Many?*
Other Animal 1
Animal Type*
Animal's Name*
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Sleeping Quarters*
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Socialibility*
Is There Any Additional Information You Would Like To Add?
Other Animal 2
Animal Type*
Animal's Name*
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Sleeping Quarters*
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Socialibility*
Is There Any Additional Information You Would Like To Add?
Other Animal 3
Animal Type*
Animal's Name*
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Sleeping Quarters*
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Socialibility*
Is There Any Additional Information You Would Like To Add?
Other Animal 4
Animal Type*
Animal's Name*
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Sleeping Quarters*
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Socialibility*
Is There Any Additional Information You Would Like To Add?

Residence
Type of Residence*
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Please Describe Type of Residence*
Do You Own or Rent?*
Does Landlord Allow Cats?*
- Yes
- No
Please Provide Landlord's Name*
Please Provide Landlord's Phone Number*
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Yard Information
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Do You Have A Yard?*
- Yes
- No
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Is The Yard Fenced?*
- Yes
- No
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How High Is The Fence?*
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What Is The Lowest Point of The Fence?*
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What Material Is The Fence Made From?*
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Please Describe Fence Material*
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Is The Lawn Treated?
- Yes
- No
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Do You Have A Pool?*
- Yes
- No
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Is The Pool Completely Fenced?*
- Yes
- No

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Family & History
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What Type Of Household Do You Have?*
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Please Describe*
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Do All Family Members Want A Cat?*
- Yes
- No
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Please Explain Who Doesn't and Why They Don't*
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Is Any Member Of Your Household Allergic To Cats?*
- Yes
- No
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Are You Willing To Take Responsibility For This Cat For The Next 15-20 Years?*
- Yes
- No
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What Provisions Will You Make For The Cat Should You Become Unable To Care For Him/Her?*
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Are You Capable of Providing Timely Healthcare?*
- Yes
- No
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What Are You Willing/Able To Spend On Annual Vet Care?*
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Please Explain Your Circumstances*
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Feeding & Exercise
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Who Will Be Responsible For Feeding The Cat?*
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Sleep & Alone Time
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Where Will The Cat Sleep?*
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Where Will The Cat Be When Alone?*
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Please Describe Where The Cat Will Be*
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Do You Have A Doggie Door?*
- Yes
- No
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Is It Locked When You Are Away From Home?*
- Yes
- No
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What Is The Longest Time The Cat Will Be Alone (without humans)?*
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Who Will Care For The Cat While You Are On Vacation?*
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Please Explain Who Will Care For The Cat*
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Behavior & Training
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Cats Can Take A Month Or Longer To Adjust To A New Home, Particularly If Other Pets Are Involved. Are You WIlling To Devote This Much Time To Make The Cat Comfortable In Your Home?*
- Yes
- No
What Behaviors Can You Tolerate (and work on)?
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Needs Social Skills*
- Yes
- No
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Accidents In The House*
- Yes
- No
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Inappropriate Chewing*
- Yes
- No
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Excessive Scratching*
- Yes
- No
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Separation Anxiety*
- Yes
- No
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Other
- Yes
- No
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Please Explain Other Behaviors You Cannot Tolerate*
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Personal Reference
Please Provide A Personal Reference
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Please Provide Reference's First Name*
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Please Provide Reference's Last Name*
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Please Provide Reference's Phone Number*
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Please Provide Reference's eMail Address*
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Relationship to Applicant*
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Years Acquainted*
Veterinarian Information
Have You Used A Veterinarian Before?*
- Yes
- No
Please Provide Veterinarian's Name*
Please Provide Veterinarian's Phone Number*
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Groomer Information
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Have You Used A Groomer Before?
- Yes
- No
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Please Provide Groomer's Name
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Please Provide Groomer's Phone Number
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Boarding Facility Information
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Have You Used A Boarding Facility Before?
- Yes
- No
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Please Provide Boarding Facility's Name
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Please Provide Boarding Facility's Phone Number

Reason For Adoption
Select all that apply.
Family Companion*
- Yes
- No
Breeding*
- Yes
- No
Farm Cat | Mouser*
- Yes
- No
For Child*
- Yes
- No
Gift*
- Yes
- No
Companion For Current Cat*
- Yes
- No
- Replace A Previous Cat*
  - Yes
  - No
- Other
  - Yes
  - No
- Please Describe Why You Want This Cat
Would You Consider:
Fostering While Waiting For The Perfect Cat?*
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Two Cats?*
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A Pregnant Cat?*
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Bottle feeding Baby?*
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A Cat That Can Be An Only Pet?*
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A Cat That Is Afraid Of Small Children?*
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A Cat That Needs Medications?*
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A Cat That Has A Serious Health Condition?*
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Please Select All Health Condition(s) You Would Accept*
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A Cat that Has Special Needs?*
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Please Select All Special Needs(s) You Would Accept*
Select All That Apply:
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A Cat That is Litterbox Trained?*
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Select Gender*
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Select Age Range*
Select All That Apply
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Select Personality*
Select All That Apply
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Select Color*
Do You Have A Preferred Cat?*
Note: This does not guarantee this cat will be placed with you
List Other Cats You Are Interested In
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When Will You Be Ready To Adopt?*
Is There Anything Else You Would Like to Let Us Know?
I am interested in receiving pet related services and products*
- Yes
- No
Authorization
Authorization:*
All of the informtion that I have given is true and complete. The cat will reside in my home as a pet. I will provide it with food, water, training, affection and routine veterinary care including monthly preventatives. I also understand that I must be 21 years of age to adopt. Your typed and signed signature signitifies that your have answered as honestly as possible and agree to our terms and conditions. Any answers found to be untruthful now or later, may result in loss of the cat, any court costs incurred to retturn the cat are the responsibility of the adopter. A representative of Field of Dreams Rescue has the right to refuse any application.*
- I agree
Comments
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Cat Adoption Application

Adoption: Cat

Employment & Schooling

Adults

Adult 1

Adult 2

Adult 3

Adult 4

Children

Child 1

Child 2

Child 3

Child 4

Cats

Cat 1

Cat 2

Cat 3

Cat 4

Other Animals

Other Animal 1

Other Animal 2

Other Animal 3

Other Animal 4

Residence

Yard Information

Family & History

Feeding & Exercise

Sleep & Alone Time

Behavior & Training

What Behaviors Can You Tolerate (and work on)?

Personal Reference

Please Provide A Personal Reference

Veterinarian Information

Groomer Information

Boarding Facility Information

Reason For Adoption

Would You Consider:

Authorization

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