Sample Animal Adoption Form - Feline Victory Rescue



Pet Adoption Application

$85 Adoption Fee (There is no fee to apply.) 

Thank you for considering a Feline Victory Rescue cat for adoption. We use this questionnaire to place each of our cats in loving, appropriate homes while maintaining open adoption policies to make for a friendly & inclusive adoption process.

All of Feline Victory Rescue’s cats have been spayed/neutered, vaccinated, tested for FIV/FeLV, and dewormed. 

Upon adoption, adopters receive a copy of the cat’s medical history. The non-refundable adoption fee is $85, cash or check. Upon receipt of this completed application, we will be in touch with you within 24 hours.

ADOPTER'S INFORMATION:

Name: Mobile Phone Number:

Date of Birth: Home Phone Number:

Address: Driver’s License Number:

City: State: Zip:

Email:

Occupation:

Place of Employment:

Do you rent or own your home? If you rent, what is your landlord’s full name and phone number?

Do you live in a: house__________ apartment_________ condo/co-op_________

Do you live with your parents or are your living arrangements contingent on anyone other than a spouse? If yes, please explain__________________________________________

Do you have any plans to move in the next 5 years? __________

How long have you lived at your current residence? __________

HOME LIFE:

Please list all the persons living in your household, with ages and relationship to you.

Does anyone in your home have animal allergies?

Does everyone agree and consent to bringing in a new pet?

Do any other dogs live in your household?

If yes, please list dogs’ name(s), age(s), and breed(s):_____________________________

Are all the dogs in your home up to date on their vaccinations?

Are all the dogs in your home spayed/neutered?

Do any other cats live in your household?

If yes, please list cats’ name(s), age(s) and breed(s):______________________________

Are all the cats in your home up to date on their vaccinations?

Are all the cats in your home spayed/neutered?

Have all the cats been tested (and the results come back negative) for feline leukemia (FeLV) and feline AIDS (FIV)?

If you have cats, are they declawed?

If yes, please provide reason for declawing, name of veterinarian who performed the procedure, and date of procedure:___________________________________________

What brand of food do you currently feed your cat(s) and/or dog(s)? Dry, canned?

If you do not currently have other cats in the household, have you owned other cats in the past? If yes, what happened to your last cat(s) and in what year?

Was previous cat declawed?

YOUR NEW PET:

Where will your new cat sleep? _____________

How many times a day do you plan on feeding your cat? Will his/her diet consist of wet food, dry food, or both? How often will you provide fresh water to your adopted pet?

What is the name and phone number of the Veterinarian you will use?________________________________________________________________

What type of flea and tick preventative do you intend to use on your adopted pet?

Please note that Feline Victory Rescue will always welcome back its cats when their current owners can no longer care for them due to accident, injury, death or change in financial circumstances. You are welcome to list FVR on this form if you should at any time need to surrender your adopted cat, and it will not influence our decision to adopt out a cat or cats to you.

Remember that most well-cared-for, indoor cats live for around 20 years. Is there any foreseeable reason why you may have to surrender this pet at any point during its lifetime? If yes, who have you chosen to take over the responsibility of caring for your cat(s)? Please list name, address and phone number:_________________________________________________________________

When you go on vacation or stay over with a friend, relative or, in the event of illness, short stay in the hospital, who will care for your pet(s) while you’re gone? Please provide emergency/temporary contact name, address and phone number: ________________________________________________________________________

Who will be the primary caretaker of this cat and how many hours/day will he/she be left alone?

Do you have the financial resources to provide food and litter for this cat, as well as both annual check-up veterinary care and emergency veterinary care in the event of sudden accident or illness?

Will you provide the necessities for travel to the vet such as a pet carrier and ID collar?

Will you provide a clean indoor litter box, soft bed, warm environment, toys, daily food and water, all necessary veterinary care and medication, exercise, affection and companionship for your cat for the rest of its life?

In your own words, please explain why you want to adopt a cat, and why you want to adopt this particular cat.

Please provide a personal reference (someone who knows you well and who would be supportive of your application to adopt a cat).

Name & relationship to you:

Phone number:

Please Note: Feline Victory Rescue is a not-for-profit organization managed entirely by volunteers who are committed to providing the animals in our care the best possible alternative to their sad lives on the streets. We must act in the best interest of our animals at all times, and therefore reserve the right to select the home that best meets the current and long-term needs of each of our adoptable animals. We will perform a background check based on the information you have provided. If there are any past or pending allegations, and/or criminal charges pertaining to animal neglect or animal cruelty against you or anyone in your household, you will be immediately disqualified as a potential adopter.

INFORMATION ABOUT THE PET OF INTEREST:

Name: Breed: Sex: Age:

Color:

ADOPTER'S AGREEMENT

• I agree that the pet being adopted is for myself and will not be sold, adopted out, or given to another party.  

• I agree that the animal will not be allowed outdoors without supervision, restraint (cat tent or cage, leash and harness, cat carrier, etc.) and without proper ID.

• I agree that I will not declaw the cat or allow the cat to roam outdoors at will.  I understand that this cat is a former feral cat, which means that he/she most likely will not return home to me of his own accord, if left unattended outside.

• I agree that this cat will live inside my home, in a household with no children under the age of 5. I will supervise any children while they interact with this cat. If there are any issues with this cat and my family members or other animals, I will make sure that this cat is kept away from any potentially dangerous animals or people who may visit my household. I further agree that, if the situation is not manageable, I will contact the original rescue to rehome this cat as soon as possible.

• If I need to be away from my home for any reason, whether overnight or for a prolonged period, I will make sure that this cat has adequate food, water, and litter, as well as a responsible caretaker, if my absence is longer than a few days.

• I agree to care for this cat in a humane manner. This includes supplying adequate food, water, shelter, temperature control, attention, and medical care.  

• I agree that if at any point I cannot keep him or her, I will return this cat to the original rescue without requesting a fee.  

• I understand and agree that Feline Victory Rescue makes no guarantees about the pet's temperament or health and agree to hold the rescue harmless in the event of damages, injuries or additional medical expenses caused by the pet.

• I give the current rescue permission to perform a home check before the adoption process is complete, to ensure that this cat will be living in a safe and loving environment. I further agree to allow calls or visits to my home at any reasonable time after adoption to ensure that this cat is being properly treated and cared for. I understand and consent to both the pre-adoption home check and post-adoption home adjustment check, as well as any subsequent pre-arranged visits, for as long as I own this cat. 

• I agree to keep the rescue informed of my current home address and phone number, should either change, for the duration of this cat’s life.  

• I agree to maintain this cat’s microchip subscription for an annual fee, payable to the microchipping company, not to the rescue, for the duration of this cat’s life. I further agree to provide reasonable medical checkups as well as any emergency medical care or medication that may be necessary, at my own expense.

I agree that all statements I have made on this form are true. If at any time, it is found that any statements I have made on this form are false, the adopted pet can be confiscated immediately and I agree to refrain from protesting or attempting to reclaim the cat in any way.

Adopter's Signature: __________________________ Date: _________________

Rescuer’s Signature: __________________________ Date: _________________

Feline Victory Rescue, Inc., a not-for-profit organization

FelineVictoryRescue@





................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download