First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Drivers license number

Are You a Veteran?

Who all lives in the home? Please provide name, age and gender of everyone. *

Does anyone in your home have allergies?*
Choose one: Yes No

Interested pet

Why do you want this pet?*

What other pets reside in the home? (How many? What kind?)*

Have you had pets in the last 10 years?*
Choose one: Yes No

If these pets are no longer with you, please tell us why.

Do you own or rent your residence?*
Choose one: Own Rent

How long have you lived there?*
Choose one: Less than 1 year 1 year 2 years 3 years 4 years 5 -10 years 10+ years

Please provide name and phone number of landowner/landlord if applicable.

If you rent, do you have permission from the landowner/landloard to have a pet?*
Choose one: Yes No Not applicable

Who is your current veterinarian? Please provide name and phone number. (We do vet checks) Also date of last visit. Most adoptions require that you have a vet reference. *

Please list the names and contact information for 2 references.*

Where would this pet spend most of its time?*

How many hours a day would this pet be left alone?*

Who will be the primary caretaker?*

How many hours a day would you spend with this pet?*

What kind of responsibility do you feel pet guardianship involves?*

If you must give up your pet, what would you do?*

One application per pet.

You must be 18 years of age to fill out this application

These pets that are up for adoption have been traumatized and/or abused and we try our very best to place them in loving forever homes so as not to add to the pet's bad experience.  We are an all-volunteer organization and sometimes it takes time to review applications.  Please be patient.  If you don't hear from us in a timely manner, please contact us. 

ADOPTION CONTRACT :  I agree to keep this cat as a pet, to be exercised regularly. I agree to assure the health and welfare of this cat by annual veterinarian check ups, vaccinations, worming and whatever else this animal may require to sustain it’s health and well being.

I agree to surrender this cat to Crossed Paws Animal Shelter, if CPAS deems it advisable to the health and welfare of the pet. I agree not to sell, trade, or dispose of this cat for any reason. If for any reason, you cannot keep this cat, it will be returned to Crossed Paws Animal Shelter

I understand that the temperament, health, trainability and personality of this cat can not in any way be guaranteed and that CPAS does not make any warranties, expressed or implied, including merchantability or fitness for a particular purpose.

I understand that Crossed Paws Animal Shelter is a non-profit organization and I do hereby release it from all responsibilities or liabilities of any kind.

The current adoption fee for this cat is $50.00, since this cat has all of its vaccinations, including rabies, and has been spayed/neutered. I understand that I am entitled to a full refund if the pet is returned in safe, healthy condition within 72 hours of this contract. NO REFUND will be issued after 72 hours of the date of this contract, and if the pet appears abused or neglected.

IF YOU ARE ADOPTING A KITTEN PLEASE READ BELOW:

 Mark which one is applicable:

___The current adoption fee for this kitten is $50.00, since this kitten has all of its vaccinations, including rabies, and has been spayed/neutered. I understand that I am entitled to a full refund if the pet is returned in safe, healthy condition within 72 hours of this contract. NO REFUND will be issued after the 72 hours of the date of this contract, and if the pet appears abused or neglected.

___IFthis kitten is too young to be spayed/neutered I being the current owner of this kitten  accepts all responsibilities in getting the animal spayed and neutered at 6 months of age.   I will provide CPAS the date when the animal is to be seen by the veterinarian so CPAS can contact the veterinarian to assure that agreed terms are being fulfilled. CPAS will provide a money voucher of $25.00 to help with the cost of the spay or neuter. 

CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT. I UNDERSTAND THAT ANY FALSIFICATIONS OF THE ABOVE INFORMATION WILL BE GROUNDS FOR DENIAL OF THIS ADOPTION APPLICATION. I HAVE READ THE ENTIRE DOCUMENT AND FULLY UNDERSTAND. I AM ABLE AND PREPARED TO OFFER THIS PET A LOVING HOME FOR THE DURATION OF HIS/HER LIFESPAN. IT IS ALSO UNDERSTOOD THAT BY SIGNING THIS ADOPTION AGREEMENT I DO NOT HOLD CROSSED PAWS ANIMAL SHELTER RESPONSIBLE FOR ANY ACTS, BEHAVIOR OR CONDITIONS THAT THIS ANIMAL MAY ENDURE. SIGNING THIS FORM MAKES ME THE PRIMARY OWNER AND COMPLETELY RESPONSIBLE FOR THIS ANIMAL.

Please type your name as your signature and date. *