Are you 18 years of age or older? *  
|(Must be 18 or older to adopt) 
 
No Yes  
 
 
First Name(s) *  
 
 
 
 
Last name *  
 
 
 
 
Title  
 
Mr 
Mrs 
Ms 
Mx 
Other 
 
 
 
Email address *  
 
 
  
Confirm email 
 
 
 
 
Door Number & Street Address *  
 
 
 
Address Notes (unit #/house colour/landmarks)  
 
 
 
 
Parish *  
 
Devonshire 
Hamilton 
Paget 
Pembroke 
Saint George's 
Sandys 
Smiths 
Southampton 
Warwick 
City of Hamilton 
Town of St George 
 
 
 
Postal Code *  
 
 
 
 
Do you own or rent? *  
 
  Own (if you own a Condo your committee will need to confirm it's ok to have this type of pet).  
  Rent (if you rent, your landlord will need to confirm it's okay to have this type of pet).  
 
 
Home Phone  
 
 
 
 
Work/Other phone *  
 
 
 
 
Mobile Phone *  
 
 
 
 
Second Applicant Name (partner, spouse, etc)  
 
 
 
 
If you are applying concerning a specific animal, please let us know its name, details etc, and where you saw the animal listed.  
 
 
 
 
I am interested in (More than one response can be selected) *  
 
 
A single cat 
A pair 
More than two 
Indoor only cat 
 
 
 
What age cat are you looking for? *  
 
 
Any age 
Kitten (0-1yr) 
Young Cat (1-4yrs) 
Older Cat (5+yrs) 
 
 
 
 
Male or female?  
 
Any 
Female 
Male 
 
 
 
 
Do you have an existing dog in the house? *  
 
No Yes  
 
 
Do you have an existing cat in the house? *  
 
No Yes  
 
 
Your existing pets are.....(choose all that apply) *  
 
 
Fully up to date with their vaccinations 
Haven't been vaccinated since being a kitten/puppy 
Have been neutered 
Fully wormed and de-flead currently 
I/We do not have any other pets 
 
 
 
Which vet do you currently use for existing pets? *  
 
Ettrick 
Endsmeet 
Cedar Tree 
BVS 
VetSmith 
No existing pets 
Don't have a vet. 
 
 
 
What provision do you have planned to allow the cat access to outside? (This is to help us with the matchmaking process as some cats, for example, are indoor only.) *  
 
Will be inside only 
Will go out into a public area 
Communal garden 
Own garden 
 
 
 
How long would the cat be left? (Please select any/all that apply) Most cats are able to be left for a while (they probably sleep) but some need more constant attention and reassurance. The purpose of this question is for us to avoid introducing you to an animal for adoption which would be unsuitable. *  
 
 
3 or 4 hours 
During the working day 
Occasionally during the day into late evening 
Overnight occasionally (please note you should by law not be leaving a cat unattended for more than 24 hours 
I am away a lot but use a sitter 
I am away a lot but the cat would go stay at the vets or a cattery. 
 
 
 
Please let us know a bit about your family and home. (Please select any/all that apply). You can comment further in the Additional Information section. The purpose of this question is for us to avoid introducing you to an animal for adoption which would be unsuitable. *  
 
 
We have young kids under 5 
We have kids between 5 and 10 
We have kids older than 10 
We have kids visiting regularly 
We have 3 or fewer adults at home 
There is only me at home 
We have other cats 
We have no cats 
We have a dog 
We have several dogs 
We have visiting dogs or cats into the house 
We have other small animals or birds in the home 
 
 
 
 
Please select any statement that applies to you. (More than one response can be selected) *  
 
 
It is very important that the animal is good with dogs 
It is very important that the animal is good with cats 
It is very important that the animal is comfortable around children 
It is very important the animal is comfortable being picked up/petted 
It is very important the animal likes to play with toys 
I need an indoor-only cat 
Being good with dogs is not that important 
Being good with cats is not that important 
Being good with young kids is not that important 
Being picked up and petted are not that important 
I am a more experienced cat owner 
I am a first time cat owner 
 
 
 
 
Additional Information (Is there anything else you would like us to know that you were not able to include above?)  
 
 
 
Do you agree that your adopted pet will receive the needed medical attention at your own expense and you are aware of the costs of preventative, routine and emergency care? *  
 
No Yes  
 
 
Do you understand that this application does not guarantee that you are able to adopt a specific named animal, or any animal, from the SPCA? *  
 
No Yes  
 
 
Do you understand that falsification of the above information may result in an adoption being declined or confiscation of the adopted pet? *  
 
No Yes  
 
 
Photo of your driving licence, Bermuda ID card or other Government issued ID. The application cannot proceed without this. *  
 
 
 
 
 
If you have a written or printed note of permission from your landlord, you can attach it here if it can be sent as a .JPG file. (At present, the software does not allow you to attach documents or PDFs to this form, but you can email or forward these to info@spca.bm-you must include your name and address so we can link them to your application). Thank you.  
 
 
 
 
 
You can sign electronically, either with your finger (on a touchscreen) or the mouse. If the signature comes out wrong, you'll be asked to re-sign it later. *  
 
 
Clear 
 
 
Date form filled in *