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Adopt An Animal

Adoption Application

_______________________
Date
______________________________________
Name
______________________________________
Address
______________________________________
City, State, Zip Code
______________________________________
County
________________________
Phone Number w/Area Code
______________________________________
Work Phone
______________________________________
E-mail Address: 

What is the intended use for this animal 
_____________________________________________

Location where animal will be housed:
__________________________________________________

Directions to property: 
____________________________________________________

Are you a current animal owner? ________ # of years __________

Number of animals owned ___________

Have you ever owned/adopted  a cat/other before? 

Yes _____ No _____ Owned? _____  Adopted? ______

Have you sold / relinquished any animals in the past 5 years? __________________ 

If yes, how many and why ______________

Who will be caring for this animal? Please give name and age 
____________________________

What is your experience with animals?
_____________________________________________

We adopt out INDOOR ONLY  Cats/Kittens.

Animals have been Vet checked and had all there vaccinations prior to being put for adoption
 ( except Rabies).  It is the adopters responsibility to continue the yearly vaccination schedule to
maintain the health of this animal.

Adopter agrees to Feed, House, and Care this animal in a Humane Manner.

If for any reason this animal is no longer wanted in the household- it is to be returned to 
Cast-A-Way Cats and not surrendered over to any other organization or group  prior to
notifying Cast-A-Way Cats.

Cast-A-Way  Cats does not refund Adoption Fees.

Describe the type of animal you are seeking to adopt: _________________________________________________

Do you have knowledge of caring for this animal?____________

Do you have litter box's in a convenient setting and food and water accessible at all times.

What type of food will you be feeding? 

Dry _____ Brand_________ 

Canned___________  Brand_________

By signing this contract you are taking the life of this animals in your hands- to care for it 
for it's entire life and provide it with the necessary items it may need for the next 18 years or more.
Are you willing to take this responsibility ______? 

Children? Yes ____ No ____ Ages _______________________

Will your children be animal friendly and responsible ______________?


Is there a specific animal that has been posted that you would like to adopt? ______________________________

I hereby acknowledge receiving from Cast-A-Way Cats the above animal which i agree to care for humanely. I certify that i am financially able to care for this animal.

I agree to take this animal to my veterinarian within 2 weeks of this adoption. I understand that my donation will not be refunded without a receipt or letter from the veterinarian stating that this animal in not suitable for adoption due to serious health problems. Cast-A-Way Cats is not responsible for veterinarian fees.

To the best of our knowledge, this animal is leaving our facility in good health. The medical history accompanies this animals paper work. There are no guarantees for this animals health once it leaves our facility and the adopter assumes the responsibility for this animals health and welfare from this date____________________.

How did you hear about us? 

Internet ____ Word of Mouth ____ Advertisement ____Petco.______Other _____

REFERENCES:

VETERINARIAN: ________________________________________

      Address ________________________________________

      _______________________________________________

      Phone __________________________________________

TWO PERSONAL REFERENCES (not related)

      Name/Address/Phone ______________________________

      _______________________________________________

      _______________________________________________

      Name/Address/Phone ______________________________

      _______________________________________________

                   ________________________________________________

Drivers License #____________________________________ 

Animal Protection Coalition, Inc. will require that all applicants have their information verified
prior to acceptance in to the Adoption Program. Each application must have a written or verbal 
recommendation from their current Veterinarian and two other adults who have knowledge of the 
applicant for a minimum of two years. Animals adopted from Animal Protection Coalition, Inc. 
include no guarantees regarding soundness or temperament. Your adoption application will be 
placed in our files. We will contact you if an animal that fits your needs becomes available for 
adoption.

____________________________________
Signature

____________________________________
Date

ADDENDUM TO APPLICATION

Name _____________________________________

How long at present address? Years ________ Months ________ 
                                              Own __________ Rent __________

If renting, landlord’s Name ___________________ Phone _________________

How many people reside in your home? ______ 
                                                ______ Adults 
                                                ______ Children - Ages ______________

Work hours (primary) ________ (secondary) ________

How many hours will dog/cat be alone? _________

Where will you keep the dog/cat when nobody is home?
____________________________

Where will you keep the dog/cat at night? 
_______________________________________

What will you do with the dog/cat if you travel? 
___________________________________

If you move what would you do with the dog/cat?
_________________________________

Does anyone have allergies in your home? _____________________________________

Is your yard fenced completely? ________

Type ____________ Height ______________

If no, how will you confine the dog/cat to your yard? 
____________________________

Current pets

Type/Breed____________________________________________________

Age__________________________________________________________

Sex__________________________________________________________

Altered?_______________________________________________________

Behavior issues _________________________________________________

If no pets currently owned, have you owned one in your adult life? ___________

If yes, what happened to him/her? __________________________________

Are you willing to obtain a crate for this dog/cat if necessary? 
_______________________

Are you willing to enroll this dog/cat in obedience classes? 
__________________________

How do you plan to exercise the dog/cat? 
______________________________________

Are you willing to give this dog/cat time to adjust to your environment which in 
some cases could take up to 3 weeks? Yes No

What would be unacceptable behavior in your home to cause you to give 
the dog/cat up? 
_______________________________________________________

I understand that in order to complete processing of this application, a visit 
to my home is required. This visit will be scheduled by a volunteer of the rescue 
group and that by submitting this application, I agree to such a scheduled visit. 
I/We acknowledge that all information contained on this form is true and correct. 
I/We understand that any misrepresentation of fact may result in removal of the
adopted dog/cat from my home by the rescue group immediately.

____________________________               _________________
Primary Adopter                                                   Date

____________________________               __________________
Secondary Adopter                                              Date

____________________________
Animal Protection Coalition, Inc.

____________________________
Signature (APC Agent)

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