HALHS Cat App – Three Rivers Humane Society

Home At Last Humane Society

Cat Adoption Application

Applicant must be 21 to adopt.

Home At Lasts Humane Society (and/or Petco if at Petco adoption center; Petsmart Aoption Center)reserves the right to refuse adoption to anyone who fails to comply withHome At Last Society’s policies. Failure to provide correct information may warrant adoption denial.
I hereby give permission to Three Rivers Humane Society to contact my veterinarian to obtain information about past and present pets. I also authorize Home At Last Humane Society to verify the below listed information.

Application Date//

Which cat are you interested in?

Applicant Name *

First

Last

Co-Applicant Name *

First

Last

Physical Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address (If Different)

Address Line 1

Address Line 2

City

State

Zip Code

Email (Required for complimentary insurance offer}

Phone *

Alternate Phone

Do you rent or own? *

Own
Rent

If You Rent, Landlord’s name and phone number (If none Write None): *

Have you ever adopted from us in the past? *

If Yes, When & who did you adopt? (If Not applicable Write N/A) *

Is this your first experience with a cat? *

Why do you want to adopt a pet? *

Companion for self
Companion for child
Gift
Companion for another pet

Where will your adopted cat live? *

Please note that HALHS does not adopt to outside only homes.

Are you prepared to meet the financial responsibility of owning a pet? A cost of $300= $500 per pet, per year? *

How many people live in your household? *

Do all the adults in the household know you plan to adopt? *

Are there children in the household? *

What are the ages of the children? (If Not applicable Write N/A) *

Does anyone living in your household have any known allergy to animals? *

If Yes, To what kind of animals? (If Not applicable Write N/A) *

Where will this cat be kept during the day? *

At Night? *

Please list your presently owned pets, if any: (If Not applicable Write N/A) *

Please list any pets you have lost or disposed of in the last 2 years: (If Not applicable Write N/A) *

What will you do if you encounter problems with your adopted animal? *

Veterinarian Information

Veterinarian Name *

Veterinarian Phone Number *

Personal Reference

Please give one reference other than your veterinarian, please include phone number/address. *

I understand that I may not declaw any cat I adopt from Home At Last Humane Society, at any time. Doing so will result in the breaking of the adoption contract, and Home At Last Humane Society may take any appropriate action for the welfare of the animal as noted in the adoption contract. I understand that this potentially debilitating procedure may lead to behavior problems. If I have any problems with my cat scratching, I will turn to Home At Last Humane Society and my veterinarian for assistance to resolve the problem effectively and humanely, without resorting to surgical declawing or a tendonectomy. I am aware that Three Rivers Humane Society has examined this cat, provided preventive medical care, and disclosed in writing all known medical issues. I understand that all animals can carry and transmit disease, some of which may affect other animals and/or people and that these diseases may be undetectable in what appears to be a healthy cat at the time of adoption. I understand that my new cat may have been exposed to contagious diseases such as ringworm and feline upper respiratory infection, and that these conditions are usually highly treatable. I understand that Home At Last Humane Society does test for feline leukemia or feline aids, I accept this cat as AS IS at the time of adoption, taking responsibility for the cat’s care and well-being, including all medical care which may be necessary after the time the cat is released into my care. I understand that Home At Last Humane Society is not responsible for any medical conditions not detected prior to the time of this adoption. I understand that I should keep my new cat isolated from other pets for a minimum of seven (7) days. My signature below indicates that I agree with the previous statement and the information contained in this application is true and no falsifications have been made.

Signature (Use you mouse to sign your name)

Type Name

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