Adoption Application

Cat Adoption Application

Pet guardianship is a serious commitment that the entire household needs to consider and agree to before the animal is adopted. We want to ensure that each adoptive household is aware of andwilling and able to accept the physical and financial responsibilities of pet guardianship. Not everyone who desires to adopt a pet is ready to properly care for one.

This application will assist both you and us in determining if your household is prepared to assume the role of responsible caretaker for a rescue animal. Please note that applying does not ensure approval. Jane’s Mission reserves the right to refuse adoptions to anyone. No animal will be adopted to prospective guardians who mislead or fail to provide accurate information on the adoption application.

Last Name	First Name
Today’s Date
Are you over 18 years old? Yes or No

Address: City: State: Zip:

Home Phone: Cell Phone: Work Phone:

1. What made you decide to adopt from Jane’s Missions?
2. Why do you want a cat?
3. Are you:	1^st time cat owner	Had cats before	Currently own	How many?
4.How much are you budgeting for your cat (food, vaccinations, etc.) $______ yearly (approx.)
5.Do you have a budget for emergency medical care, if needed?
6.Which veterinarian will you go to for annual boosters and other medical care?_________________ Vets phone #________________ and address_________________________
7.Who will be the primary caretaker of the cat?________________________________
8.Have you discussed cat guardianship with all people living with you?_________________ How many people live in your household?______
9.Are you, and those who live with you, committed to spend 12+ years providing health care, food, grooming and attention? ____________________
10. This cat/kitten will be: c inside only c outside only c both?
11. A kitten is required to stay inside until it is 6 months of age, altered and fully vaccinated. Are you ableto keep this kitten inside only for the first six months? c Yes c No Why not?______________________________________________________________
12 a.Where will your cat be during the day?________________________________ At night?______________________________________ 12 b. Where will the cat be kept while alone?_______________________________ While you are home?_____________________________ 12 c. What will you do with your cat while you are away on vacation or out of town?____________________________________________________________
13 a. What problems would make you return an animal? c Scratching furniture c chewing c marking c shyness/fear c not getting along with other animals c other (explain)_________ _______________________________________________________________________
14. If this cat does not get along with your other pets, what will you do about it?_____________________________________________________________________
15. What are you planning to feed your cat?________________________________________
16. Have you ever brought an animal to a shelter? If yes, why?_____________________________________________________________________
17. Have you ever put a pet down? Why?___________________________________________
18. Have you ever given an animal to another person? If yes, why?________________________
If you are currently the guardian of other pets, please provide the following information: Type of Animal Breed Breed Sex Age Vaccines Current? Altered Where kept? Exact location please (e.g., garage, run, etc.)
19. Do you rent? Y N Do you own? Y N c House c Apartment c Mobile Home c Condo
20. Is the lease/contract in your name? Y N

If you rent, or have a lease option, we will need to contact your landlord

Landlord's Name/Management Co..________________________________________

Address:_______________________________________________ Phone #:__________

Authorization:_____________________ By: ___________

Provide two references that can speak to your character:

Name:

Address:

Phone:

Time Known:

Briefly describe relationship:

Checked_____Comments_______________________________________Approved__________

Name:

Address:

Phone:

Time Known:

Briefly describe relationship:

Checked____ Comments_______________________________________Approved__________

The answers to the above questions are true and to the best of my knowledge.

I will not give away or otherwise transfer the animal to another party without notifying Janes Mission. I realize that failure to comply with Jane’s Mission Contract and the above stipulations may result in confiscation of the adopted animal.

Jane’s Mission reserves the right to inspect the cat's disposition when deemed necessary. Before approval of application we may conduct a home visit to ensure the cat will be getting the best home for it’s needs.

Applicant's Signature_______________________________________ Today's Date_____________

For Office Use Only

Driver's License #: ______________ Adoption #:___________Interviewed by: ______________

Animal Description: __________________________________________________________________

ID verification ------------c

Address verified ----------c

Landlord verification -----c N/A

Spay/Neuter date----------c

Approval -------------------c Yes c No Interviewed by: ______________________

Reason for denial: ___________________________________________________________________

_________________________________________________________________________________

Jane’s Mission

Schenectady NY 12304

518-374-1839

http://janedemartino.tripod.com