Cat Adoption Application

Animal(s) you are interested in adopting (you must be at least 21 years old to adopt) *
Applicant's First Name *
Middle Initial *
Applicant's Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Phone Number * Please use the following format 248-555-1212
Email Address * Please enter correctly as this is the main way we will contact you
Alternate Phone Number
Date of Birth *
Drivers License Number
How did you find out about us?
Have you applied anywhere else for a pet? *
If yes, where else and when have you applied for a pet?
Is this pet for you or someone else? *
Do you have other pets at the current time? *
If yes, please list their names, breeds, and ages. *
Are all of your pets spayed/neutered/fixed? *
How many pets have you had in the last 15 years? *
List the names, breeds and ages of each of those pets.
What happened to each of them? (If deceased, how did the pet die?) *
Are your pets current on their vaccinations? * Rabies and distemper
Have you ever rehomed a pet or surrendered your pet to a shelter? *
If yes, please explain?
Are you planning to declaw your cat? *
Provide the names of each of the veterinarians to whom you have brought your pets during the past 15 years. * If you have never owned a pet please tell us where you would go.
Provide the addresses of each of the veterinarians to whom you have brought your pets. * Again if you have never owned a pet please list where you would go
Provide the telephone numbers of each of the veterinarians to whom you have brought your pets. *
Have you contacted each of your present and past veterinarians to authorize release to The Animal Haven of information regarding your current and past pets? * Without these authorizations, we are unable to process your application.
Have you ever had a pet euthanized? *
If yes, please explain: *
How do you feel about having pets spayed/neutered? *
If you have pets, will they adjust to a new pet in the house? *
Please check the main reason you plan to adopt a pet: *
If you answered "other" above, please explain here:
Please describe in detail the pet you are looking for. *
Do you own or rent your home? * If you rent or own a condo, we will need to see the lease/by laws
Please select your current residence type. *
If you own or rent, please upload your lease/by laws stating that pets are permitted.
If you answered "other" above, please explain here: *
How long have you lived at this address? *
If you rent, does your landlord and lease allow pets? *
Including yourself, how many people live in your household? *
Please list the ages & relationship of those who live in your home. *
Does everyone in your household agree to adopt a pet? *
Do any of the residents in your home have allergies to any type of animal? *
If yes, who has allergies and what type of allergies does he/she have? *
What would you do if a family member became allergic to the cat? *
Employment Status *
If you chose "other" above, please explain: *
If you are employed, what is your current occupation? *
On average, how many hours per day will your pet be left alone? *
How much do you think the annual medical bills will be for your pet? *
What would you do if the bills went over this amount? *
Would you get insurance for your pets? *
Will your cat be an indoor only cat or an indoor/outdoor cat? *
Please provide a description of the pet's living conditions. *
Are you willing to consult a behaviorist or trainer if needed? *
What behaviors are you not willing to work on? (e.g., biting, scratching furniture, meowing) *
Will you keep the animal up-to-date on vaccinations and yearly physical examinations? *
Have you ever been convicted of abuse or neglect of a child or animal? *
If yes, please explain: *
What arrangements will you make for the care of your pets in case of an emergency? *
If you answered "other" above, please explain:
In whose care do you intend to leave the cat if you become permanently unable to care for the cat? * Please provide NAME, PHONE NUMBER, and RELATIONSHIP to you. This is a MANDATORY step in the application process.
What will you do with the animal when you go on vacation? *
If you answered "other" above, please explain: *
What would you do with your animal if you had to move? *
If you answered "other" above, please explain: *
For what reason(s) would you consider returning/giving up the animal? * e.g. new baby, shedding, nipping biting, scratching, scratching furniture, allergies, divorce, litter box issues, pet's health, child's loss of interest, travel, pet's age, conflict with other pet(s), conflict with family member, marriage, moving
Are you willing to take responsibility for this animal for the next 10-20 years? *
Will you allow us to perform a home check? *
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. I am also aware that The Animal Haven cannot guarantee the health and/or temperament of the animal(s) that I am interested in adopting. *
I HEREBY RELEASE AND DISCHARGE THE ANIMAL HAVEN AND ITS OFFICERS, EMPLOYEES, AGENTS, DIRECTORS, VOLUNTEERS AND CONTRACTORS FROM ALL ACTIONS, CLAIMS, OR DEMANDS THAT I, MY HEIRS, GUARDIANS, AND/OR LEGAL REPRESENTATIVES NOW HAVE, OR MAY HAVE IN THE FUTURE, FOR ANY PERSONAL INJURIES, PROPERTY DAMAGE AND/OR OTHER DAMAGES CAUSED BY ANY OF THE ANIMALS AT THE ANIMAL HAVEN WHEN I VISIT THE ANIMAL HAVEN , INCLUDING ANY DAMAGES DUE OR CLAIMED TO BE DUE TO ANY NEGLIGENCE OF THE ANIMAL HAVEN, ITS OFFICERS, EMPLOYEES, AGENTS, DIRECTORS, VOLUNTEERS AND/OR CONTRACTORS, AND I HEREBY WAIVER ANY SUCH CLAIMS *
Please sign *
Date *
Please provide 2 references (names, phone numbers and their relationship to you) * These must be people who do not reside in your home.