Cat Surrender Application

Owner First Name *
Owner Surname *
Street Address *
City *
State *
Post Code *
Phone Number *
Email Address (non NT Gov or NT Schools email addresses please)(Please check spam folder as you will get an automatic email once you submit this form and future emails may also go there) *
Animal Name *
Gender *
Breed *
Date of Birth *
Coat Type *
Colour *
Is your cat microchipped *
Microchip Number
Microchip Company
Is your cat Desexed *
Is your cat up to date on vaccinations *
Last Vaccination Date
Last Vaccination Type
Vet Name
Vet Contact Number
Vet Records can be supplied (Records required for all information above) *
Does your cat have any known health issues? *
Health issues
Other please explain
How long have you had your cat? *
Where did you get your cat? *
Good with cats? *
Good with dogs? *
Good with Kids *
Housetrained? *
Has your cat ever killed or drawn blood on another animal? *
If yes above please supply details?
Has your cat ever attacked or drawn blood on a human? *
If yes above please supply details?
Any other behavior issues we should be aware of?
Has you cat been living: *
Why are you choosing to surrender your cat? *
I require my cat to be rehomed prior to: *
Are you prepared to work with Paws so we can assist you with behavioural issue and help you try and keep your cat? *
I understand that a surrender fee is payable upto $400 dependant on the circumstances *
I understand a microchip transfer fee and FIV testing may incur further charges up to $25 each dependant on circumstances * I understand a microchip transfer fee and FIV testing may incur further charges up to $25 each dependant on circumstances
I understand that once accepted by Paws I will surrender all rights to my cat and Paws will have sole and exclusive right to make all outcome decisions and take all actions deemed appropriate including adoption or euthanasia. I will not be kept informed of any decisions made or actions taken. *
I acknowledge that I am the legal owner of the animal above and all information provided is true and accurate to the best of my knowledge. *
Signature of Applicant. Please use your finger on touch screen or click and hold your left button to use your mouse above the line. * Please sign on screen or click and hold your left button to use your mouse.
Date *
Please enter your photographic identification *
Please up load a picture of the animal you are wanting to surrender *
Please upload Vaccination Records
Please upload Desex Certificate
Please upload Microchip Certificate