shelterlisttest – CUFA-WI

test

test2

Not able to create a Petfinder V2 access token. Please make sure your API Key and Secret are set correctly on the plugin's settings page.

Adoption Application

Name of animal you are interested in adopting (optional)

First Name *

Middle Name *

Last Name *

Address *

Address

City

State/Province

Zip/Postal

Home Phone

Cell Phone *

Email *

Social Media Handles

Please list all people (including you) that will be living in the household with your new cat. Include the persons FIRST, MIDDLE INITIAL AND LAST NAME, AGE, GENDER, and RELATIONSHIP to you. *

Do ANY members of the household have a history of cat allergies? *

Yes

Has everyone in the household discussed and agreed to meet and potentially adopt the animal? *

Yes

If you RENT or LEASE, please provide the landlord/owners information. Include the rental complex name, LANDLORD'S NAME and PHONE NUMBER. All residences will be verified.

Type of Residence *

House

Duplex

Townhouse

Living with Relative/Friend

Apartment

Condo

Mobile Home

OtherOther

Does your lease allow you to have a pet? *

Yes

How long have you lived at your current address? *

Are you planning to move within the next 6 months? *

Yes

Do you plan to keep this cat indoors? *

Yes

Please describe circumstances

VETERINARY INFORMATION. Please list CLINIC NAME and PHONE NUMBER.

If you do not currently have a vet, please list the name and number of the vet you plan to use. We will follow up in the future to ensure the adopted animal is on file with them.

VETERINARY CHECK. Please list the name that is on your current and previous pets records.

We check vet references prior to approving applications. Please contact your vet to give them permission to release information to us.

If you've owned pets before, please list all pets owned within the last 5 years below.

Please list Name, Type of animal, breed and amount of time you've had this pet. Do you still have this pet? If not, why?

Details - Choose all that apply.

Spayed/Neutered?

Female

Male

Kept Inside

Kept Outside

Both Indoor/Outdoor

Pet Current on Vaccinations

Add Another Pet Remove

Are veterinary records listed under the name on the application? *

Yes

Have you ever adopted from, or submitted an application to a shelter/rescue before? *

Yes

If Yes, please list when, from where and the type of pet you applied for.

Have you ever surrendered an animal to a shelter? *

Yes

If Yes, please list when, and the reason.

Why do you want to adopt a pet? Please select all that apply. *

Companion

Companion for Another Animal

For a Child

Gift

To Teach Responsibility

Protection

Watch cat

OtherOther

Are you willing/able to assume the financial responsibility of pet ownership? *

Yes

How much money do you plan to spend per year to care for your cat? *

How many hours a day will your cat be without human companionship? *

Please Note: Kittens should not be left more than 3-4 hours a day without human companionship and need a feline buddy to avoid developing Single Kitten Syndrome.

Where will you keep your cat during the day when you are gone? *

Where will you keep your cat at night? *

Are you a frequent traveler? *

Yes

Who will care for your cat during vacations, business trips, etc.? *

Will you commit to caring for your new cat for the next 10-15 years? *

Yes

If you must move from your current place of residence, what will you do with your cat? *

Will you allow your cat adequate time to adjust to a new home? *

Yes

How long? *

What do you know about the needs of felines when they transition into a new environment? *

Would you like more information about assisting your feline transition to your home? *

Yes

Are you willing to work with a cat that needs additional work? Please check all that apply. *

Furniture Manners

Counter Surfing

Litterbox Behavior

Nightime Zoomies

Rough Play or Prey Behavior

Door Dashing

Scratching

I am not willing to work with a cat on any of these issues

How will you correct behavior problems in your cat if they occur? *

Are there any "deal breakers" for your family in regards to behavior? If so, what? *

If your cat needs additional obedience training, are you willing to cover the costs at your expense? *

Yes

Are you planning on declawing your cat? *

Yes

Are you familiar with the cat responsibility and liability laws in your area? *

Yes

REFERENCE #1: Please provide the name, address and phone number for a personal reference. *

REFERENCE #2: Please provide the name, address and phone number for a personal reference. *

I certify that the information provided in this application is complete and accurate to the best of my knowledge and that you are hereby giving your consent for Citizens United For Animals to verify any and all information contained herein. I understand the completion of this form does not entitle me to any guarantees or rights and I further understand that that Citizens United For Animals reserves the right to deny my request to adopt an animal for any reason. I, along with those persons who may accompany me, assume risk of injury which may be incurred as a result of my viewing any animal under the care of Citizens United For Animals and that Citizens United For Animals will not be held liable in any way, for any animal, or its actions, once the animal has been placed. Please "sign" by typing your name below. *

If you are human, leave this field blank.