Cat Adoption Application

Step 1 of 5 – Personal Information

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Personal Information

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address City State ZIP Code

Home/Cell Phone(Required)

Home/Work Phone(Required)

Driver's License No(Required)

State(Required)

Are you 21 or older?(Required)

Yes

Are you currently employed?(Required)

Yes

Household Information

How long have you lived at your current address?(Required)

Do you plan to move within the next year?(Required)

Yes

Do you(Required)

Own

Rent

Live with Relatives

Live with Roommates

Type of Residence(Required)

Apartment

Condo

House

Duplex

Farm

Student Housing

Other

Other(Required)

If renting, Landlord/Property Name?

Landlord/Property Phone

Pet Deposit Amount

Does the pet policy allow cats and are there any specific veterniary requirements for owning cats? (i.e. spay or neuter, declawing, etc.)

Ages of all household members(Required)

Has anyone in the household ever been convicted of a felony?(Required)

Yes

Pet Information

Have you ever adopted from KPA before?(Required)

Yes

Have you ever owned a cat before?(Required)

Yes

Was it a good or bad experience?(Required)

PIease list all pets you have had in the past 10 years and the reason you no longer have them. (Died of old age, euthanized, gave away, ran away, hit by car, etc.):(Required)

Have you ever had to surrender a pet?(Required)

Yes

Please explain(Required)

Have you ever had to reclaim a pet from a pound or had a pet runaway?(Required)

Yes

Please explain(Required)

Have you ever allowed a pet to breed?(Required)

Yes

Please explain(Required)

Animal Care Information

How much do you expect to spend on this pet YEARLY?(Required)

$50-$100

$100-$200

$200-$400

+$600

Please list all of the pets currently living at your residence:(Required)

Species/Breed, Sex(M/F), Altered(Y/N), Age, Indoors/Outdoors/Both, Current on Vaccines(Y/N), Time Owned

Current Veterinarian:(Required)

Phone(Required)

How many hours will this pet be left alone daily?(Required)

What would happen to this pet if you had to move?(Required)

What would happen to this pet if a household/family member became allergic?(Required)

What would happen to this pet in the event of your death?(Required)

Where will this cat spend its time when you are at home?(Required)

Where will this cat spend its time when you are away from home?(Required)

Where will this cat spend its time when you are sleeping at night?(Required)

Where will this cat spend its time when you are out of town?(Required)

If you have children, or plan to extend your family, are you comfortable with the possibility of a child being scratched or bitten by this cat?(Required)

Under what circumstances would you declaw this cat?(Required)

When driving, how will your pet be contained?(Required)

Back Seat

Lap

Crate in Car

Crate in Pick-Up Truck Bed

Other

Which of the following are you WILLING to work with?(Required)

Chewing

Litter box training

Excessive vocalization

Scratching

Marking

Hyperactivity

Animal Aggression

Human Aggression

Mild biting

Shyness

Allergies

Inappropriate Behavior (clawing furniture, climbing etc.)

Check all that apply

How do you plan to discipline this pet if they misbehave?(Required)

Reasons you would return this cat(Required)

Litter box issues after 1-4 weeks

Chewing

Excessive Vocalization

Marking

Shyness

Allergies

Scratching

Hyperactivity

Mild biting

Animal Aggression

Human Aggression

Inappropriate Behavior (clawing furniture, climbing, etc.)

Check all that apply

Agreement

I certify that the submitted information is true and complete. I understand that giving false information on this application is grounds for immediate denial. I understand that the KPA reserves the right to deny an adoption request for any, or no, reason and that KPA may choose not to reveal specific reasons. I hereby grant permission for the landlord and veterinary offices above to speak to a representative of KPA to discuss information related to my ownership of my pets.

I understand that by signing this form I may be subject to a background check and screening.

Signature(Required)

I certify that the information on this application is true. Please enter your name, and today’s date:

Date(Required)

Comments

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

Personal Information

Household Information

Pet Information

Animal Care Information

Agreement

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Mailing Address

Office Address

Phone

Who we are

Ambassador

KPA! has donated $3,200 to KCAS to cover the adoption fees for every pet adopted through December.