Skip to content
(520) 571-7839
Instagram
YouTube
Twitter
Facebook
Home
Adopt
Submit Your Adoption Story
Donate
Donate Now
Buy A Brick
Sponsor A Cat
Cans for Cats
Planned Giving
Corporate Sponsorships
Wish List
Volunteer
Foster
Volunteer Login
Events
Event Registration
Kid’s Club
Cat Yoga
Community Programs
Resources
Intake Form
Trap, Neuter, Return
Continuing Cat Care
Food for People’s Pets
Other Shelters
Partner Vet Clinics
No Kill Advocacy
About
Board of Directors
Staff
Tabby Tabloid
Media
Annual Reports / Financial Information
Contact
Home
Adopt
Submit Your Adoption Story
Donate
Donate Now
Buy A Brick
Sponsor A Cat
Cans for Cats
Planned Giving
Corporate Sponsorships
Wish List
Volunteer
Foster
Volunteer Login
Events
Event Registration
Kid’s Club
Cat Yoga
Community Programs
Resources
Intake Form
Trap, Neuter, Return
Continuing Cat Care
Food for People’s Pets
Other Shelters
Partner Vet Clinics
No Kill Advocacy
About
Board of Directors
Staff
Tabby Tabloid
Media
Annual Reports / Financial Information
Contact
Home
Adopt
Submit Your Adoption Story
Donate
Donate Now
Buy A Brick
Sponsor A Cat
Cans for Cats
Planned Giving
Corporate Sponsorships
Wish List
Volunteer
Foster
Volunteer Login
Events
Event Registration
Kid’s Club
Cat Yoga
Community Programs
Resources
Intake Form
Trap, Neuter, Return
Continuing Cat Care
Food for People’s Pets
Other Shelters
Partner Vet Clinics
No Kill Advocacy
About
Board of Directors
Staff
Tabby Tabloid
Media
Annual Reports / Financial Information
Contact
Adoption-Form
2018-08-21T11:21:07-07:00
Adoption Application
Date of Application
*
MM
1
2
3
4
5
6
7
8
9
10
11
12
/
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
YYYY
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Applicant's Name
*
Applicant's Date of Birth
*
MM
1
2
3
4
5
6
7
8
9
10
11
12
/
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
YYYY
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Co-Applicant's Name
Co-Applicant's Date of Birth
MM
1
2
3
4
5
6
7
8
9
10
11
12
/
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
YYYY
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Applicant's Driver's License Number & State of Issue
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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
Email
Submit