| Date: |
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| Time: |
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| Name of Cat you are interested in adopting?: |
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| Name: |
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| Address: |
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| Phone Number: |
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| Date of Birth: * |
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| Email Address: |
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Spouse's Name:
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| Spouse's Date of Birth: * |
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| Landlord's Name and Phone Number: * |
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| Employer's Name and Phone Number: |
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| Does anyone suffer from allergies?: |
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| Is everyone in home aware of and agreed upon adopting a pet?: |
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| How frequently do you travel for business or pleasure?: |
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| What will you do with the cat while traveling?: |
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| How many hours will your cat be left alone?: |
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| Housing Status: |
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| Who lives in your household?: |
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| Housing Type: |
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| Describe what you are looking for in a cat: |
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| Would you ever have a cat declawed?: |
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| Why do you want a cat?: |
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| Who will be responsible for feeding and changing the litter box?: |
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| Where will you keep the cat?: |
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| Under what conditions would you give up your cat?: |
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| Please list all animals that have shared you home in the past 5 years: (Please include Name, Breed, Sex, Age, & if spayed/neutered): |
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| Are all animals in your home up-to date on vaccinations (Rabies & Distemper)?: |
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| How much do you think it costs, per year, to own a cat?: |
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| Are you willing to spend the money necessary for updating shots on time, spay/neutering and emergency care for your pet?: |
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| Please list your current and past veterinarian for a reference: |
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| Please provide two personal references and phone numbers.: |
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| Have you ever adopted an animal?: |
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| Have you ever surrendered an animal?: |
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| Have you ever been cited or convicted of a crime relating to animal cruelty, or do you have a charge pending?: |
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| I will allow a rescue representative to perform a pre-adoption home check: |
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| I will allow a rescue representative to visit my home later to check on the animal I am adopting: |
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| I am aware that the adoption donation is non-refundable: |
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| Would you be willing to foster cats/kittens?: |
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| Would you be willing to volunteer for CFA?: |
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| We do not guarantee the health of any animals offered for adoption. Any time you adopt an animal, you should take it to a licensed veterinarian as soon as possible. Your animal is, to the best of our knowledge, healthy, but will need to be started immediately on a program of preventative veterinary care. Please be aware that the animals available for adoption are rescue animals and, as such, have often been exposed to a variety of diseases. Your cat/kittens was tested for FeLV and FIV upon admission into CFA and tested negative unless you are specifically adopting a cat/kitten that tested positive for FeLV or FIV. Like human illnesses, these diseases can have an incubation period of up to several months. If the animal you adopted shows signs of illness at any point, you must take it promptly to your veterinarian for treatment at your expense. I have read and understand this disclaimer. Please initial in box. |
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| By signing this application, I acknowledge that I have answered all questions truthfully. Failure to provide truthful answers can result in the forfeiture of your adopted pet to Chesapeake Feline Association. Chesapeake Feline Association requires a background check and will contact your landlord and veterinarian before allowing the adoption to take place.: |
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