Cat Adoption Application

Welcome to the FCHS Adoption Program. The following information is requested so that we can assist you in the selection of a new cat.

This form and consultation with a FCHS representative are designed to help you find the cat most compatible with your lifestyle and is in the animal's best interest.

 

Completion of this application DOES NOT guarantee adoption of a FCHS cat.

In order to be considered as an adopter you must:

Franklin County Humane Society Be 21 years of age or older
Franklin County Humane Society Have identification showing your present address
Franklin County Humane Society Have the knowledge and consent of your landlord
Franklin County Humane Society Be able and willing to spend the time and money necessary to provide medical treatment and proper care and nourishment for a pet

 

What cat are you considering adopting?

ID # Date:
Cat Name: Cat Age:

Applicant Information

Name: E-mail:
Address:  
City: State: Zip Code:
Phone Number: Alternate Phone Number:
Your Age: Driver's License Number:
Are You Within City Limits?
Home's Location:
How long have you lived at this residence? Years Months
Do you live with your parents/relatives?
Are you currently: (check all that apply)    
Employed Full Time    
Employed Part Time    
Unemployed    
Student    
Retired    
Other Please Explain:
If Employed, Name of Employer  
Job Title/Line of Work  
If Student, Where  
Does your job require extensive travel?
Please list all names and ages of adults in your household:
 
 
Please list all names and ages of children in your household:
 
 
 
Do you or any member of your household have allergies to cats?
Are ALL members of your household aware of and in agreement with this adoption?
Do you Rent Own your home?    
Is your home a House Condo Mobile Apartment
If you rent, please provide
Landlord Name: Landlord Phone Number:
If you rent, are you familiar with you landlord's pet policy?
What is your landlord's pet policy?
     

Adoption Information

   
What is the reason(s) you want to adopt this cat? Check all that apply.
Love animals, want to help an animal in need  
Companionship  
Companion for other pet  
My children will learn responsibility  
Want to breed  
Looking for mouse/rodent control for home, garage, barn, or other  
Office cat  
Gift for someone


 
Explain:

 
       
Do you have screens on your windows?
Do you have a cat/dog door?
Where will your cat live?
What type of food do you plan on feeding?  
Will you have the cat declawed?
Are you willing to provide yearly vet care for your new pet?
What is your estimate of annual routine vet care costs for your new pet? $
How much are you willing to spend on medical bills for your cat? $
What would you do if the vet bills go over this amount?  
If you go away for a few days, or on vacation, who will take care of your pet?  
What arrangements will you make for the care of your pet in case of an emergency or if you become unable to care for him/her?  
If you move, will you take the pet with you?
If you are no longer able to keep your pet you adopt, do you agree that you must either return the animal to FCHS or find a suitable new home for it and notify FCHS of the change in ownership?
Furthermore, do you agree that if you cannot keep the animal you adopt, you must continue all care, everyday needs, proper housing, medical attention, etc. for this animal until a suitable home is available or until space is available at FCHS?
     

Current And Past Pets

   
What animals do you currently own?    
Type: (cat, dog, bird, lizard, etc)   Age:
Breed: Altered:
Where Obtained:
Type: (cat, dog, bird, lizard, etc)   Age:
Breed: Altered:
Where Obtained:
Type: (cat, dog, bird, lizard, etc)   Age:
Breed: Altered:
Where Obtained:
Type: (cat, dog, bird, lizard, etc)   Age:
Breed: Altered:
Where Obtained:
Are your current pets licensed?
Do your current pets wear identification tags?
Are your pets’ vaccinations up to date?
If you have other cats, have they been tested for feline leukemia?
Who is your current vet? Vet Phone Number:
Vet Address:

Please list what pets you have owned in the past:

   
Type: (cat, dog, bird, lizard, etc) Age: Breed:
Altered: Deceased:
If they are still living, why are they no longer with you?
Type: (cat, dog, bird, lizard, etc) Age: Breed:
Altered: Deceased:
If they are still living, why are they no longer with you?
Type: (cat, dog, bird, lizard, etc) Age: Breed:
Altered: Deceased:
If they are still living, why are they no longer with you?
Type: (cat, dog, bird, lizard, etc) Age: Breed:
Altered: Deceased:
If they are still living, why are they no longer with you?
Please tell us about the animal’s weekly schedule as it relates to your schedule. Which hours of the day will your pet routinely be home alone? (For example, if everyone is at work/school between 8-4 on Monday, you would write 8-4 in the Monday box.)
Monday Tuesday Wednesday Thursday Friday
  Saturday Sunday
When away where do you plan to keep your pet? (Check all that apply.)
Free inside Garage Enclosed in a room Basement
In a crate Outside    
Where will your pet be kept at night?
Free inside Garage Enclosed in a room Basement
In a crate Outside    
How will you introduce your new pet to any existing pets?  
How do you plan to handle undesirable behavior such as accidents in the house, spraying, scratching furniture, excessive crying, or getting on to counter tops?
Who will be primarily responsible for this pet? Name Age
Are you aware that this pet can live to be 15 to 20 years old?
How did you hear about us? Check all that apply.    
  Media Website Petsmart
  Other Shelter Word of Mouth Petco
  Adopted Before    
Do you understand our right to choose the best possible environment for this pet and our right to approve or deny this adoption application?

I am aware that this pet may exhibit undesirable behaviors such as biting, house soiling, etc. and that it's my responsibility to spend time with and train my pet.


FCHS is not responsible for any damage which this animal may inflict on another animal, person, or property and that no attempt will be made by me to hold FCHS responsible for such damage.

 

I am aware that FCHS is not responsible for any medical conditions not detected prior to adoption and discovered more than 7 days following adoption. I must go to my complimentary vet visit to validate the 7-day health guarantee. The guarantee excludes any conditions disclosed to me and agreed to by me at the time of adoption.

 

I am aware that the spay/neuter surgery must be performed within 30 days of adoption and provide proof in the form of a receipt or certificate.

I, the undersigned, certify that all of the information contained on this application is complete and accurate and any misrepresentation will cause me to be denied, or if discovered after adopting, void any adoption and any rights of ownership.

Signature:   

Agree with terms:
Franklin County Humane Society | Union Missouri
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