Cat Adoption Application

Copy the following application and paste it into an email to fill it out.

Dire Straits Companion Animal Rescue

CAT ADOPTION APPLICATION

Name of pet you are applying for:

Date:

Applicant/Co-Applicant Information

Last Name, First Name, DOB:

Last Name, First Name, DOB:

Address:

Apt #

City, State and Zip:

Home Phone:

Cell Phone:

Email Address:

Do you own?

Rent?  Landlord’s Name, Phone:

How long have you lived at this address?

Any plans to move in the near future?

Family/Household Information

Number of adults in the household:

Relationships:

Have all the adults in the household agreed to this adoption?

Number of children in the household and their ages:

Have the children had pets before?

Do you expect your current family situation to change?

Is anyone in the household allergic to cats, if yes, who?

What are your reasons for adopting a cat?  (Check all that apply)

____ Companion for self    ____ Companion for other household member   ____ Gift
____ Companion for child    ____ Companion for other pet    ____ Other (explain)

Employment Information

Employer and position held:

Address:

Work phone:

How long have you been with this employer?

Pet Information

Please list current pets:

NAME              BREED              AGE          MALE/FEMALE        SPAYED/NEUTERED?

1
2
3
4

Have you ever given an animal away or relinquished an animal to a shelter?

If yes, what were the circumstances?

Has a pet ever gotten lost?

Has a pet been hit by a car?

Have you had a pet euthanized?

Explain any “yes” answers:

Are your current pets up to date on vaccines/heartworm preventative?

Veterinarian/Clinic Name:

Phone:

New Pet Information

How much time are you prepared to allow for your new cat to adjust to your home?

How much do you expect to spend on maintenance for your cat in a year?

Are you able to afford a bill of $300-$900 (or more) for emergency veterinary care?

Are you committed to providing a responsible, loving home for your cat’s entire life (15+ years)?

If you have to move, what do you plan to do with your pet(s)?

Who in the household will be the cat’s primary caregiver?

When you are out of town, who will be the cat’s primary caregiver?

In case of emergency, who will care for your cat?

How many hours per day will your cat be left alone?

Where will the cat be kept during the day?

At night?

Will your cat be kept indoors, outdoors or both?

Will your cat be allowed outside?

Do you plan to de-claw your cat?

References – Please list 3 personal references who are not related to you.

1 (Name)

(Relationship)

(Phone Number)

2 (Name)

(Relationship)

(Phone Number)

3 (Name)

(Relationship)

(Phone Number)

By signing below, I certify that the information I have given is true. I understand that Dire Straits Companion Animal Rescue reserves the right to deny my application for any reason. I further authorize the investigation of all statements in this application.

Applicant:

Date:

Co-Applicant:

Date:

Please email application to: AdoptYourPet@direstraitsanimalrescue.org