PITTSBURGH C.A.T. APPLICATION

Who are you interested in adopting?

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Name of primary caregiver

Please note that the primary caregiver must be the one applying

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Address where the cat will be living

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Primary phone number

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E-Mail address

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Are you financially secure enough to responsibly provide for a cat's medical care?

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Are you over 21 years old?

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Have you ever had a cat before?

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Where are those cats now?

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Have you ever relinquished a companion animal to a shelter, rescue organization, or another family?

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If yes, please list the name of the shelter, rescue, or other agency and the reason you relinquished.

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Are you allergic to cats?

Yes
No
I am not sure

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Where will your cat spend their time?

Indoors only
Indoor/Outdoor (ex. unsupervised or not on a leash or in an enclosed area)
Indoors/Outdoors with supervision or in enclosed area (ex. covered patio, catio, on a leash)

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Do you own your own home or rent?

I own my home
I rent a house
I rent an apartment
Other:

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If you rent, does your lease state that you are allowed to have a cat?

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If you rent, please provide the name, address, and phone number of your landlord

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List all members of your household

How many people live in your household?

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Name of household member #1

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Age

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Relationship to adopter

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Name of household member #2

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Age

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Relationship to adopter

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Name of household member #3

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Age

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Relationship to adopter

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Please list any additional household members. Include NAME, AGE, RELATIONSHIP

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How many animals are in your home?

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Animal # 1's name, breed, and age

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Animal #2's name, breed, and age

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Animal #3's name, breed, and age

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Please list any additonal pets. Include NAME, BREED, AGE.

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Are you considering declawing?

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If yes, for what reason?

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Who would watch your companion animals if you were away from home (on vacation, away for work, etc)

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What would you do if you were somehow no longer physically or financially capable of caring for this companion animal?

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Veterinarian Information

Are all companion animals in the home spayed, neutered, and up to date on vaccinations?

yes
No
Other:

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Name of vet where current or former animals would be on file. List any that apply.

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Phone number of vet

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Pittsburgh C.A.T. routinely contacts applicants' veterinarians as part of our adoption screening process. Do we have your permission to contact your veterinarian to verify your pet(s) health records and vaccination status?

IF YES, PLEASE CALL YOUR VET AND TELL THEM THEY HAVE YOUR PERMISSION TO RELEASE RECORDS TO US SO THAT WE CAN EXPEDITE THE APPLICATION PROCESS.

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BINDING TERMS AND CONDITIONS

I hereby agree to the following adoption terms and conditions for the cat/kitten which is to be placed into my home: 1. I agree to keep this cat/kitten indoors and to provide it with food, fresh water, shelter, and kind treatment at all times. 2. I agree to take this cat/kitten to a veterinarian for yearly exams and immunizations per my veterinarian’s advice. I will also seek immediate veterinary attention for this cat/kitten should it become ill or injured. 3. I agree to protect this cat/kitten from abuse/neglect and to not allow it to be used for experimental purposes. 4. I agree that, if for any reason whatsoever, the adoption of this cat/kitten proves unsatisfactory or if I am no longer able to provide adequate care for the cat/kitten, I will contact Pittsburgh C.A.T. to make arrangements to return the cat/kitten to their care. I will not place the cat/kitten with any other person or shelter/rescue group. Pittsburgh C.A.T. will make arrangements, which may include picking up the cat/kitten from the home, within a reasonable period of time. I understand that if I return the cat for any reason that my adoption fee is NON-REFUNDABLE. 5. I agree to allow a representative from Pittsburgh C.A.T. to call or visit my home in order to ensure that the cat/kitten is receiving the proper care. Pittsburgh C.A.T. also has my permission to contact my veterinarian anytime in the future to ensure that proper veterinary care is being given to the cat/kitten as per this agreement. 6. I understand that the temperament, health, or training of this cat/kitten cannot be guaranteed in any way. A copy of the cat/kitten’s vaccination has been provided to me. 7. I understand that, by signing below, I hereby release Pittsburgh C.A.T. harmless for any and all animal bites, scratches, and/or any other injuries or death that may occur to me, members of my family, or any other people/animals by the cat/kitten. I agree to hold Pittsburgh C.A.T. harmless for any and all damages or destruction done by the animal to my property or to any other property with which the cat/kitten named comes into contact with. 8. I understand that this contract is a legal adoption agreement, that all the conditions must therefore be followed, and that this cat/kitten cannot be sold or given to anyone else without the express written consent of Pittsburgh C.A.T. 9. I agree that if at any time I feel I am unable to be bound by any and all terms of this contract, I will immediately notify Pittsburgh C.A.T. to reclaim custody of the cat/kitten. 10. I agree to NOT at any time, for any reason DECLAW the cat(s) included in this contract or any cat adopted from Pittsburgh C.A.T. 11. I understand that the cat that I am adopting is surgically sterilized and microchipped for their safety.

Acknowledgement of Contract

I hereby agree to all of the above terms and conditions. I have read, or have had read to me, the above agreement which was explained to me by a Pittsburgh C.A.T. Representative; and I agree to be legally bound by the terms and conditions stated. I certify that I am twenty-one (21) years of age or older, of sound mind and conscience, and a resident of Pennsylvania. I certify that all of the information given to Pittsburgh C.A.T. in this application is true and correct. I understand that my request to adopt any animal may be denied for any circumstance or situation that could be deemed not to be in the best interest of the animal, or is determined to be in violation of state or local ordinances. I authorize investigation of all statements in this application. I also authorize my veterinarian to release any information that would be helpful in determining my suitability as an adopter to a representative of Pittsburgh C.A.T. Pittsburgh C.A.T. reserves the right to take back adopted cat/kitten if this signed contract is not being followed.

Name

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Initials

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