PITTSBURGH C.A.T. APPLICATION
Who are you interested in adopting? *
Your answer
Name of primary caregiver/adopter *
Please note that the primary caregiver must be the one applying to adopt.
Your answer
Address where the cat will be living *
Your answer
Primary phone number (10 digits with hyphens) *
Your answer
E-Mail address
Your answer
Age of primary caregiver/adopter *
Your answer
Have you ever adopted or applied to adopt from Pittsburgh CAT before? *
Are you a student? *
If you are a student, where?
Your answer
Are you a US Citizen? *
If no, please explain (country of citizenship, student visa, work visa, etc).
Your answer
Are you financially secure enough to responsibly provide for a cat's medical care? *
Your answer
Have you ever had a cat before? *
Where are those cats now? *
Your answer
Have you ever relinquished a companion animal to a shelter, rescue organization, or another family? *
If yes, please list the name of the shelter, rescue, or other agency and the reason you relinquished.
Your answer
Are you or any household member allergic to cats? *
Where will your cat spend their time? *
Do you own your own home or rent? *
If you rent, does your lease state that you are allowed to have a cat? *
If you rent, please provide the name, address of your landlord
Your answer
If you rent, please provide phone number (10 digits with hyphens) for your landlord.
Your answer
How many people live in your household, including yourself? *
Your answer
List all additional members of your household, do not include yourself
Name of additional household member #1
Your answer
Age
Your answer
Relationship to adopter
Your answer
Name of additional household member #2
Your answer
Age
Your answer
Relationship to adopter
Your answer
Name of additional household member #3
Your answer
Age
Your answer
Relationship to adopter
Your answer
Please list any additional household members. Include NAME, AGE, RELATIONSHIP
Your answer
How many animals are in your home? *
Your answer
Animal # 1's name, breed, and age
Your answer
Animal #2's name, breed, and age
Your answer
Animal #3's name, breed, and age
Your answer
Please list any additonal pets. Include NAME, BREED, AGE.
Your answer
Are you considering declawing? *
If yes, for what reason?
Your answer
Who would watch your companion animals if you were away from home (on vacation, away for work, etc) *
Your answer
What would you do if you were somehow no longer physically or financially capable of caring for this companion animal? *
Your answer
Veterinarian Information
Are all companion animals in the home spayed, neutered, and up to date on vaccinations? *
Name of vet where current or former animals would be on file. List any that apply. *
Your answer
Phone number of vet (10 digits with hyphens)
Your answer
Phone number of 2nd vet if applicable (10 digits with hyphens)
Your answer
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. BY NOT CALLING AHEAD, YOU MAY SIGNIFICANTLY SLOW DOWN THE PROCESSING OF YOUR APPLICATION.
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 *
Your answer
Initials *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service
Google Forms