CAT ADOPTION APPLICATION
Thank you for visiting the Olympic Peninsula Humane Society. This questionnaire will help us to help you select the right pet for your particular lifestyle.
Adoption fee includes first vaccination, surgical sterilization, free health examination certificate, rabies vaccination and a microchip with local and national registration.
At the time of adoption you will be issued a free health examination certificate good at many veterinary offices on the North Olympic Peninsula. Please use this certificate within 3 business days of your adoption. If the animal is determined to be ill by the veterinarian during this period, you may return him or her to the shelter for a full refund. Failure to use this is certificate could result in forfeiture of the opportunity for refund. You may choose to treat any illness found; however, OPHS will not be responsible for any veterinary charges.
Applications are kept on file for 60 days.
Phone#: Home _________________Cell _________________
Physical Address:_______________________________________________________________________________ Street City State Zip
Do you live in a: 0 House 0Apartment 0 Mobile Home 0Condo 0 Duplex 0 With Parent/Relative Other____________________________
2. Do you: 0 OWN 0 RENT
3. Landlord Name:_____________________________________ Phone:_______________________________
4. How long have you lived at your current residence?____ Do you plan on moving within the next 6 months?_____
5. If you move in the future what will you do with your pet(s)?____________________________________________
6. How many adults live in the home? _______ How many children? _______ Children’s ages: ________________
7. Who will be responsible for the cat? ________________________________________________________
8. Why are you adopting this cat? Check all that apply. 0My companionship 0Family companionship 0Gift 0Mouser 0Breeding Other?__________________________________________
9. Have you adopted an animal from us before? _____ When? _________________Do you still have the animal?_______ If not, what happened to the animal?____________________________________________________________
10. Do you have a fenced yard? ________ What type of fencing?_____________________________________
11. Where will the cat live? 0 strictly inside 0 strictly outside 0 both inside and outside
12. Where will the cat sleep at night? 0 inside 0 outside
13. How many hours a day will the cat be left alone?______________
14. Where would the cat stay when you are not home? Check all that apply. 0 loose inside 0 confined inside 0 loose outside 0Kennel/run/fenced area outside
15. Describe your home’s activity level? 0 busy, active, noisy 0 moderate coming and going 0 quiet
16. Would you spay or neuter this cat? _________________ Why?_______________________________________
17. Would you declaw this cat? _____________________ Why? ________________________________________
18. Are you aware that it costs an average of $200 – $500 a year to own a cat? _____________________________
19. Have you ever surrendered a pet to an animal shelter?______ When?_______ Why?_____________________
20. How much time will you allow your new cat to adjust to your present pets and/or new home?________________ __________________________________________________________________________________________
21. What problems would cause you to return an animal? Check all that apply. 0 house/litter box training 0 shyness/other fears 0 scratching/climbing on furniture 0 illness Other: Please describe:____________________________________________________________________
22. Would you be committed to work with the animal to correct any of these and most other problems?____________
23. What pets do you currently have in your household?
Type Spayed/Neutered Kept Where How Long Owned? Age #1 0 dog 0 cat 0 yes 0 no 0inside 0outside ______________ ___________ #2 0 dog 0 cat 0 yes 0 no 0inside 0outside _______________ ___________ #3 0 dog 0 cat 0 yes 0 no 0inside 0outside ______________ ___________ #4 0 dog 0 cat 0 yes 0 no 0inside 0outside _____________ ___________ #5 0 dog 0 cat 0 yes 0 no 0inside 0outside _______________ ___________
Other:_________________________________________________________________________________________ 24. Do you have a veterinarian? 0Yes 0No Clinic Name:________________________________________
25. May we contact your veterinarian? 0Yes 0No
26. Are you willing to provide a lifetime home for this pet, medical treatment and specialized obedience training? 0Yes 0No If not, why?_____________________________
27. Individuals who adopt an Olympic Peninsula Humane Society animal may be contacted periodically for an update to help ensure that the animal successfully adjusts to its new life. If you adopt an OPHS animal, do you consent to home visits before and/or after adopting this pet? ___________________________
** I certify that the above information is accurate to the best of my knowledge and understand that falsification of information can be cause for denial of my application or future forfeiture of the adopted pet.
** Shelter staff reserves the right to deny adoption applications for any reason that does not comply with the philosophy of our organization.
_______________________________________________ __________________________ Signature of Applicant Date