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Online Adoption Form
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| Name of Cat |
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| Your First Name |
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| Your Last Name |
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| Spouse/Roommate’s First Name |
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| Spouse/Roommate’s Last Name |
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| Street Address |
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| Appt or Suite |
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| City |
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| ZIP Code |
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| Home Phone |
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| Cell Phone |
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| Work Phone |
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| Email |
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| Occupation |
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| Are There Children in the House? |
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| If yes, how many? |
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| If yes, their ages? |
Under 2
2 - 4
5 - 7
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8 - 10
11 - 13
older 13
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| Expecting any? |
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| Do you live in a... |
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| How long Have You lived There? |
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| Do you own or rent? |
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| If Renting, do you have Landlord's permission to own a pet? |
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| If Renting,
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| Landlord's First Name (REQUIRED) |
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| Landlord's Last Name (REQUIRED) |
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| Landlord's Phone (REQUIRED) |
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| Do you have a Fenced Yard? |
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| A member of CARE may visit your home prior to pet placement. Is that o.k.? |
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| Please tell us about any pets
you currently have or
plan to have in the home.
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| Current Pet 1 - BREED:
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Spayed/Neutered?
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| Current Pet 2 - BREED:
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Spayed/Neutered?
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| Current Pet 3 - BREED:
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Spayed/Neutered?
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| Current Pet 4 - BREED:
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Spayed/Neutered?
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| Do you need more space to complete?
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| Why do you want to add another pet?
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| Please tell us about any pets you
had in the past. If you no longer
have this pet, please tell us why
(be specific).
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| Kittens need supervision. If you are
adopting a kitten into a home with
children what special attention will
you provide?
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| Veterinarian's Name |
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| Veterinarian's Phone |
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| What circumstances would cause
you to give up your pet?
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| Do you plan to put an I.D. collar on this cat? |
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| What happens to the cat if you move?
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| What type of food do you intend to feed your pet?
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| Will you allow this pet access to the outdoors? (REQUIRED) |
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| If yes to above, where? |
Yard
Garage
Patio
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Balcony
Other
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| If yes to above, how often? |
Always
Sometimes
Only during the day
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| Under what circumstances? |
Under supervision
On a leash
Unsupervised
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| If yes to above, please give an explanation
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| Do you have a cat or dog door? |
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| Are you looking for a declawed cat? |
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| Where do you intend to keep the cat litter box?
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| Pets can claw and chew furniture,
tear window screens, dig in potted
plants. How do you plan to deal with
these or any other potential problem?
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| How many hours a day will the cat
be left alone? |
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| How often do you travel? |
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| Who will be responsible for the cat
routinely and/or when you are away?
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| Are you aware that an indoor cat can
live an average of 15 years or longer? |
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| If you are a Senior Citizen, what
provisions do you have for this animal
if you should proceed it in death?
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| If Senior, Designated Person's First Name (REQUIRED) |
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| If Senior, Designated Person's Last Name (REQUIRED) |
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| If Senior, Designated Person's Phone (REQUIRED) |
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| Is anyone in your family allergic
to animals? |
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| On the first night home, where will the cat stay?
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| Why did you choose this particular cat?
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| Are you aware that there is an annual
financial commitment for responsible
pet ownership that includes annual
vaccinations, routine veterinary care,
food and supplies? |
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| Are you willing to provide adequate
medical care if this cat should
become sick or injured? |
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| In which ways did you learn about |
CARE web site
Facebook
Newspaper
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| CARE having animals available for |
Petfinder.com
Media
Best Friends Network
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| adoption? |
Veterinarian
Friend
Other
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| If Veterinarian, Name |
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| Veterinarian's Phone |
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| Comments;
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