Adoption Application – Kitty Kat Haven & Rescue

PLEASE NOTE!! IF YOU JUST COMPLETED THE APPLICATION AND CLICKED SUBMIT AND YOU ARE STILL SEEING THIS MESSAGE THE APPLICATION DID NOT COMPLETE SUCCESSFULLY. If there are no errors, when you click Submit (all required fields have been completed) you will be taken to a new page with a confirmation message. IF there are errors you will remain on THIS page and errors will be indicated below this block of text. The fields in error will be highlighted red. You may have to scroll to ensure you see the errors.

While we try our best applications may take several business days to process and approve. Please be patient and alert your references they may be receiving a call.

STOP!! PLEASE CLICK HERE to read these important FAQs about the adoption process before proceeding!

Application for Adoption of a Feline

"*" indicates required fields

Items with an * are required. Failure to complete those items will not allow the form to submit. IF YOU DO NOT SEE A CONFIRMATION MESSAGE AFTER SUBMITTING GO BACK AND CHECK FOR MISSING MANDATORY INFORMATION. Also, please check your spam folder to ensure you receive followup communications related to your application.

What is Your Interest in Adopting?*

Adult

Kitten

Either Adult or Kitten

Comments

Name (Both First and Last Names are Required)*

Address*

Street Address Address Line 2 City State ZIP Code

Email (Please ensure email address is entered correctly)*

Phone*

Is this a Cellular Phone?*

Yes

Age*

Please note that Haven policy is all adopters must be 21 years of age or older.

Do you rent or own?*

Please be aware that if you rent, most places require a pet fee and will only allow (2) cats

Please select the one that best describes your current residence*

House

Condo/Townhome

Apartment

Mobile Home

How long have you been at your current residence?

Do you plan to move within the next two years?

Yes

Number of persons in current residence INCLUDING yourself*

List ages of all persons in current residence INCLUDING yourself*

Current Employer*

If you are retired or not currently employed please note that information in this field. If you are Self-Employed please state that and then provide the nature of your business.

Are you a student?*

Yes

School*

Will the Kitty reside with you at your current location?*

Yes

If not, where and with whom?*

References (PLEASE DO NOT INCLUDE A SPOUSE/PARTNER/SIGNIFICANT OTHER OR A MINOR CHILD AS A REFERENCE. DO NOT USE YOUR VET AS A PERSONAL REFERENCE UNLESS A PERSONAL FRIEND AND YOU ARE PROVIDING THEIR PERSONAL NUMBER. THERE IS SPACE TO PROVIDE YOUR VET INFORMATION LATER)

Reference Name #1 (Provide first and last names)*

Tel:*

Relationship:*

Reference Name #2 (Provide first and last names)*

Tel:*

Relationship:*

Financial Responsibility for New Kitty:

Who will be responsible for the cost of ownership of the new kitty?

Responsibility for Daily Care & Feeding:

Who will be responsible for the daily care activities for the new kitty?

Is anyone in the home allergic to cats?*

Yes

If you answered Yes to the previous question please explain who is allergic and reason why you believe owning a cat will not be an issue.*

Pet Ownership History

Have you owned a pet within the past 5 years?*

Yes

Do you currently own a pet?*

Yes

Veterinarian Information. This is required if you currently own a pet or have owned a pet within the past 5 years.

Name of Vet Clinic*

Please indicate the name of your current or previous vet. Even if you do not currently own a pet but have had one within the past 5 years please list that vet.

Vet Clinic Tel:*

This field is hidden when viewing the form

Vet Clinic Tel: OLD

Is this your current vet or previous vet?*

Current

Are your pets' records listed under your name? If not, under whose?*

This should be a person’s name. NOT the name of a pet.

Previous vet(s) if current vet relationship is less than seven years*

I hereby grant permission for any veterinary office(s) I have been involved with currently or in the past to discuss information related to my pet ownership and care with any KKHR representative. Please note – lack of approval to do a vet check may impact our ability to process your application.

Initial here for vet check approval*

Are there other pets not owned by you in the residence?*

Yes

If you answered yes to either of the prior questions regarding pets in the residence, please fill out information below. This section should be used to list your pets as well as pets not owned by you but in the residence (e.g., a roommate’s pet). For species/breed – an example would be Dog/Golden Retriever. TO ADD MORE ROWS FOR ADDITIONAL PETS please click the + sign at the end of the row/section.

TO ADD MORE ROWS FOR ADDITIONAL PETS please click the + sign at the end of the row/section.*

Name

Species/Breed

Age

Gender

Spayed/Neutered?

Declawed?

Been around cats?

Owned by you?

This information is required if you have indicated you currently own a pet or another’s pet lives in the residence

This field is hidden when viewing the form

How many cats have you had as an adult (ones you were responsible for)? Please enter numbers only. Put 0 if no cats as adult.

Have you ever owned a cat as an adult (one or more you were responsible for)?*

Yes

Under what circumstances have you lost a prior cat or pet? Check all that apply.*

I have never owned a pet

I have not lost a pet

Inside/outside pet that did not return home or was found deceased

Inside pet who got outside and did not return home or was found deceased

Died due to illness or injury

Other

If you have previously lost a pet through going missing or death, or you selected Other above, please provide more details.*

Have you ever surrendered or rehomed a pet?*

Yes

If yes, where was the pet surrendered to? Check All that Apply.*

Shelter/Pound

Rescue Group

Rehomed Privately

What were the circumstances leading to the surrender?*

Have you ever had a pet with a serious behavioral problem?*

Yes

If yes, please describe the situation and tell how you handled it?*

If you adopt a cat where will the cat be kept (please select one)?*

Inside

Outside

Inside/Outside

If you indicated inside/outside or outside please describe outside living space.*

Where will the cat usually stay during the day?*

Where will the cat stay at night?*

On an average day, how long will the cat be left alone?*

When the cat is left alone, where will it be kept?*

Will the cat have access to a pet door?*

Yes

If so where does it lead?*

Do you currently own a declawed cat?*

Yes

Have you ever declawed a cat?*

Yes

If yes, how long ago?*

Do you plan to declaw the cat adopted from KKHR?*

Yes

Some cats require several days or even weeks to acclimate to their new environment, family, and other pets. Are you willing to allow for this adjustment period?*

Yes

Unsure

Are you prepared for common behavior problems such as clawing, nibbling, or litter box accidents?*

Yes

What methods, if any, will you use to discipline your new pet?*

If you are away for any extended period of time, please explain your care plan for Kitty.

Are there any circumstances which would cause you to give up this cat?*

Signature

By printing your name and date below, you affirm the following: that the information on this application is true and complete to the best of my knowledge. I am aware that falsification of ANY information on this application is grounds for refusal of adoption. I further understand Kitty Kat Haven & Rescue (KKHR) reserves the right to deny any adoption for any reason.

Date

MM slash DD slash YYYY

Phone

This field is for validation purposes and should be left unchanged.