Adoption Form

Applicant's Name *

Date of Application *//

Applicant's Date of Birth *//

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

Co-Applicant's Name

Co-Applicant's Date of Birth//

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

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

How will you handle it? *

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

Yes
No

What will you do with your cat upon deployment? *

Are you a student? *

Yes
No

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

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

Have you had a kitten before? *

Yes
No

Where are they now? *

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

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

Yes
No

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

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