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Printable Cat and Kitten Adoption Application
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Cat and Kitten Adoption Application

Applications take our Adoption Counselor typically 24-72 hours to process. You will be contacted by email or phone call; please check both your email and voicemail for potential messages. Our adoption fees for adults are $20, kittens between 4 and 8 months are $35, and $70 for kittens between 2 and 4 months (covers full vetting, spay/neuter, microchip, and care of the cat). Adoption fees are payable via cash, credit, or debit; we no longer accept checks. Fees will be paid at the time of adoption and may vary. Submitting this application does not mean you are committing to a cat, nor does it guarantee you will get that cat.  It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle. A successful adoption depends on selecting the right cat for your household and a good understanding of the cat's needs and care requirements.  Please help us with this process by answering the following questions fully & completely. THANK YOU!

 

**Please note that any fields left blank will halt the application reviewing process.


Applicant Information

 Adopter #1  Name: ____________________________________D.O.B ___/___/___

 Adopter #2  Name: ____________________________________D.O.B ___/___/___

Adopter #1 Phone Number ___-___-____   Email: ______________________________

Adopter #2 Phone Number ___-___-____  Email: ______________________________

Adopter #1 Are you currently employed? ______________________________________

Adopter #2 Are you currently employed?: _____________________________________

Home Address:

Street Name ___________________________ City/State/ZIP _________________

Do you live in (circle):  single family     duplex/twin        apartment      condo       mobile home

Do you (circle):        own       rent       deed/rent to own        reside with relative

If you are not the owner of the home, please provide the homeowner’s information (name and contact information: __________________________________________________

How long have you lived at this residence? ________________________

List any residences you have had in the last 5 years: ____________________________


Household Information

Please list full names and ages of all permanent residents 18 and older: _________________

__________________________________________________________________

Ages of all permanent residents 18 and younger: ________________________________

__________________________________________________________________

Do you have frequent visitors between the ages of (circle):

0-5 years           6-12 years        13-18 years    None of the above

Does anyone in the household have pet related allergies? __________________________

Who in the household will be the pet’s primary caregiver? __________________________


Pet Ownership

Have you adopted from the Quincy Humane Society in the past? If so, where is the pet now?

__________________________________________________________________

Do you currently have any pets?  ___________________

If you currently have pets, please list them. Name, Age, Sex, Breed. ____________________

__________________________________________________________________

__________________________________________________________________

 

Are they up to date on vaccinations?     Yes      No       Appointment is scheduled

Are they altered? (spayed/neutered)     Yes      No       Appointment is scheduled

How many pets have you owned in the past 10 years? Where are they now?(Please list breed & age)

__________________________________________________________________

__________________________________________________________________

Who is your veterinarian? Clinic Name __________________ Phone: _______________


Home Life

When will you be ready to adopt a cat/kitten? __________________________________

How many hours a day will your cat be alone? Explain. ____________________________

How will you exercise/entertain your cat? _____________________________________

How often will you scoop the litter box/change the litter? __________________________

Do you plan on declawing your cat? Circle:       Yes                    No

Why or why not? ______________________________________________________

How much do you reasonably feel you could afford/would be willing to spend on your cat per

month? (Including veterinary care, licensing, ID tags, food, toys, crates, supplies):  $ ________

Ideal Cat

Please describe your ideal cat. We will be able to recommend a perfect fit based on what you say

here. _____________________________________________________________

__________________________________________________________________

What kind of cat are you looking for? Circle       Indoor    Outdoor     Indoor/Outdoor

What Personality type are you looking for? (circle all that apply)

Party Animal: loves to play, explore and test my limits

Sidekick: good company, likes attention and playtime

Love bug: affection seeking, lap cat, enjoys quiet time together

Secret Admirer: you might not see a lot of me but I'll be thinking of you, will warm up to cuddle time with purrs and headbutts

Private investigator: stays out of trouble and will always keep your secrets, may vanish into thin air if anyone interferes with my investigation

Why do you want to adopt? (Circle)

family pet        companion for child        companion for other dog(s)         companion for other cat(s)

breed with current cat(s)        barn cat/mouser        therapy cat        assistance to the disabled

guard cat/protection                as a gift for a friend/partner/relative

My adopted cat will (circle):

be indoors        be outdoors        outside during the day/inside at night        roaming the farm

interacting with adults        interacting with ages 0-10 years        interacting with ages 11-18

be boarded for vacations        stay with family for vacations         go with on vacations

be given away if it’s no longer working        be given to a shelter if it’s no longer working

Have you discussed this adoption with all members of the household?________________

**We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a cat added to this family. Please do not submit this application if you are "trying to talk someone into" adopting this cat or think that "once they meet the cat they will change their mind" or "I'm getting this cat as a surprise birthday present for someone". In those circumstances, you are more than welcome to email us to discuss the cat, but we would like all adults in the home to be involved in the email discussion.


What do you feel is a reasonable amount of time for a cat to adjust to a life with you and your

family? ___________________________

How do you plan to integrate this cat into your family? ____________________________

Have you ever turned an animal in to a shelter? ________ Why? ____________________

 

__________________________________________________________________

What would cause you to return a cat? _______________________________________

__________________________________________________________________

Please take time to think and be honest when answering the following. What are you absolutely

NOT willing to deal with at the time of adoption or anytime during the life of the cat? Circle

litter box issues        chewing        counter surfing        fear of men        fear of women

fear  of children        biting                jumping         too rough with other pet        

too much energy        needs too much attention        food/toy aggressive with people      

whining/crying         scratching furniture          blindness          limited sight                deafness

separation anxiety        diabetes        special diet        long term medication                incontinence

requires too much training         gets stressed/sick in the car        doesn't know how to use stairs

can’t climb stairs due to age/health        heart condition        allergies

        

trimming nails        yeast on coat/in ears                eat mites        fleas        ticks        

We will do anything necessary to help this cat adjust


What would you do if after adoption (or at any time during your cat’s life) your vet diagnosed your cat with an expensive medical condition? _________________________________

_________________________________________________________________

Do you plan on getting pet insurance?         Yes         No         I will look into it

Are you committed to providing a responsible home for your pet’s entire life? (could be 15 or

more years)                 Yes                 No

Are you willing to sign a legal contract agreeing to pet owner responsibility?         Yes        No

Do you have any additional questions, comments or concerns? Anything else you would like us to know in order to help match a cat with your family? ____________________________

__________________________________________________________________

__________________________________________________________________

What is the best way to contact you regarding your application?  Phone     or      Email


Consent:

By my signature, I certify that the above information is complete and correct and that I am at least 18 years of age. I understand that completing this application does not guarantee I will be allowed to adopt a cat and that the application is a tool to help the Quincy Humane Society determine if this cat and my family are a good fit for each other. I understand that all cats adopted from QHS will be spayed/neutered, Feline Leukemia and FIV tested, microchipped, and vaccinated prior to adoption. I authorize verification of all statements on this application, including but not limited to prior vet medical history. I understand that QHS has the right to deny my request for adoption. I understand that any misrepresentations may result in my not being approved and may lose the privilege of adopting an animal from QHS. If I am approved to adopt a cat, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption. I understand that this application is the property of the Quincy Humane Society who reserves the right to share this information with other shelters and rescue organizations.

_____ By initialing this line I understand that QHS may conduct a background check and I agree to the above statements.

Adopter #1 Signature & Date   _________________________________

Adopter #2 Signature & Date   _________________________________