Stillwater Cat Haven: Adoption Application

Please note, Stillwater Cat Haven is a rescue facility seeking permanent homes for our cats. Every effort is made to ensure compatibility between cat and the new owner before the new owner takes the cat home. Please answer the following questions as accurately as you can. This will help us with our placement proceedure, but does not guarantee a cat will be placed in your home.

NAME_________________________________________ DATE_____________________

ADDRESS________________________________________________________________

HOME PHONE____________________ WORK PHONE_______________________

CELL PHONE_____________________ EMAIL_______________________________

D/L# OR PHOTO ID______________ REFERENCE ________________________________

EMPLOYER____________________________________ HOW LONG?_____________

1. Are you prepared to be responsible for the costs involved in pet ownership, including annual vaccinations, routine care, dental cleaning, flea control, worming and daily feeding? ___________

2. What about emergency medical treatment/Veterinary care if needed? _____________________

3. Do you live in a: House___ Condo ___ Apt ___ Mobile home ___ Other ___

4. How long at current home? ____________ *Rent or Own __________

**Other______________________________

* If Renting, is Landlord aware of your desire to adopt a cat? _______
Please provide Landlord name and phone number _____________________________________

** If Other please explain ________________________________________________________

5. How many adults in household? ______ Children (ages) ______________________________

Does everyone agree to adopt this cat, is anyone allergic to animals?_____________________

6. Who will ultimately be responsible for this cat's care?________________________________

7. Do you agree to schedule a home visit within the first year of this adoption?_____________

8. Have you ever been a client of a Veterinarian locally______ Name? ___________________

9. Do you have any objection to us contacting your Veterinarian? _______________________

10. Have you owned a cat before? ____________ Have you ever had any pet removed by any
agency, shelter or animal control facility? ______________ Why ____________________________________________________________________________

11. Why have you decided to adopt a cat today? ____________________________________________________________________________

12. Will this cat be kept indoors _________ outdoors _________ both? ____________________________________________________________________________

13. Cats have been known to occasionally claw/scratch furniture, drapes and dig in potted plants. Have you considered this possibility and planned how to handle the problem should it occur? ______________________________________________________________________

14. Do you have intentions of having the cat declawed or a tendonectomy performed? ____________________________________________________________________________

15 Will you be moving in the near future? _______ If yes what will happen to this cat? ____________________________________________________________________________

16. Do you travel frequently? _____________ Who will care for the cat? ____________________________________________________________________________

17. Under what circumstance would you NOT keep this cat? ____________________________________________________________________________

ANIMAL COMPANION HISTORY

Please list the pets that you have now, or have owned

SPECIES BREED ALTERED INDOOR/OUTDOOR WHAT HAPPENED TO PET?

1.__________________________________________________________________________

2.__________________________________________________________________________

3.__________________________________________________________________________

4.__________________________________________________________________________

5.__________________________________________________________________________

TERMS AND CONDITIONS

I am adopting the cat listed here as my permanent family pet. I agree to provide annual Veterinary exams, vaccinations and all necessary medical care for the life of the cat. If, for any reason, during this cats lifetime, I am unable to properly care for it or to provide a quality permanent home, I agree to contact Stillwater Cat Haven (1) for assistance in placing this cat in another appropriate home (2) to return the cat directly to Stillwater Cat Haven.

I understand that the cat I am adopting has been rescued. It may have come to Stillwater Cat Haven from a previous owner who could not care for it, as a stray/feral rescue or it may have been abandoned. During this cats stay at Stillwater Cat Haven, it has been vaccinated and has been spayed/neutered. It has been examined by a Veterinarian and given any medical care that was needed. There is always a chance that this cat has been exposed to a virus, such as an upper respiratory infection. I agree to be financially responsible for Veterinary costs, if any, associated with continuing care. I agree to obey all local laws regarding pet ownership, including care, feeding, sheltering and licensing. (Where required)

I am at least 18 years of age and have provided verifiable identification. I have read and agree to the above listed terms.

Signed ______________________________________________ Date ___________________

Stillwater Cat Haven Representative signature _______________________________________