Adoption-Form - Hermitage Cat Shelter

Date of Application *//

Applicant's Name *

Applicant's Date of Birth *//

Co-Applicant's Name

Co-Applicant's Date of Birth//

Applicant's Driver's License Number & State of Issue *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email

I opt in to receive email communications from Hill's Pet Nutrition. *

Yes, opt in
No, opt out

Are you interested in a particular cat? If so, who?

Personal Information

Do you rent or own? *

Rent
Own

If renting, please list Landlord's name.

Landlord's Phone Number

How long have you been at your current address? *

Employer's Name *

How long have you been employed at your current job? *

Please describe what you do at your job. *

How many people are living in your household? *

How many children are living in your household? *

Does anyone in your house have allergies to cats? *

Yes
No

If Yes, how will you handle it?

Are you a member of the Active Military or Reserves? *

Yes
No

If Yes, what will you do with your cat upon deployment?

Are you a student? *

Yes
No

If Yes, where is your hometown?

If Yes, what will you do with your cat during school breaks and upon graduation?

Please complete if you have not already selected a specific cat so that we can help you make a selection.

Age of cat desired

Kitten (under 6 months)
Teenager (7 months - 1 year)
Adult (1-6 years)
Senior (7+ years)

Please check all that apply

Sex of cat desired

Male
Female
No Preference

Cat hair preference

Short
Medium
Long
No Preference

Please check all that apply.

Any color preference?

Is this cat a gift? *

Yes
No

If Yes, does this person reside in your house?

Yes
No

Please list all pets you currently have in your household, include names, breed and ages. *

Do you have a doggie door? *

Yes
No

What other pets have had in the past? What happened to them? *

Have you had a kitten before? *

Yes
No

If Yes, where are they now?

Have you ever had to turn a pet into a shelter or re-home it before? *

Yes
No

If Yes, please explain.

If you currently have cats, have they been tested for FeLV and FIV?

Yes
No
Not Sure

If you currently have cats, are they declawed?

Yes
No

If Yes, why were they declawed?

Do you intend to have your new cat declawed? *

Yes
No
Unsure

Are you aware of the alternatives to declawing? *

Yes
No

Where will your cat live? *

Indoor Only
Outdoor Only
Indoor & Outdoor

Do you have a fenced in yard? *

Yes
No

Do you currently have a veterinarian? *

Yes
No

If Yes, please list your veterinarian's name.

If your cat becomes seriously ill or injured and requires expensive veterinary care, how will you handle this? *

What is your contingency plan in the event you may become physically unable to care for your cat? *

How will you discipline your cat? *

Are you prepared to make a lifetime commitment to your new cat? *

Yes
No

If your cat doesn't use the litter box appropriately are you willing to take them to the vet to determine if it is a medical or behavioral issue and are you willing to try to solve the problem? *

Yes
No

If you travel, how will you care for your cat? *

How did you hear about The Hermitage? *

Please list any information you would like us to know about you.

References

Reference #1 Name *

Reference #1 Relationship *

Reference #1 Phone Number *

Reference #1 Email *

Reference #2 Name *

Reference #2 Relationship *

Reference #2 Phone Number *

Reference #2 Email *

By submitting this application, I attest that the information I have provided is true and I understand that giving false information will result in my application being denied. The Hermitage No-Kill Cat Shelter & Sanctuary reserves the right to deny the adoption of a cat to anyone that The Hermitage feels will not provide a loving and responsible home for that animal. I understand that this application is property of The Hermitage and I authorize investigation of all statements in this application, references, landlord approval and background. Check if you understand. *

I understand

Adoption Application

Personal Information

Please complete if you have not already selected a specific cat so that we can help you make a selection.

References