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Jane's Mission Cat Rescue and Adoptions

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Adoption Application
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Adoption Application


Kind Hearted Woman


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:

1st 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 Sex Age Vaccines


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:




Time Known:

Briefly describe relationship:







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


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