Little Orphan Angels Cat Adoption Application

In order to be considered for an adoption today you must:

1.     Be 21 years or older.

2.     Have identification showing your present address.

3.     Have the knowledge and consent of all adults living in your household.

4.     Be able and willing to spend the time and money necessary to provide the training, medical treatment, and proper care for your cat.

5.     For the adopted cat, have the cash to pay an adoption fee (LOA accepts checks with a valid Texas Driver’s license).

6.     Understand that LOA has the right to deny or approve your application; understand that this application will be retained in our files.

 

Animal's Name:
Your Name:
Spouse or Partner's Name:
Address:
City:
State:					Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territory Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Is. Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
Home Phone:
Place of employment of you or spouse:
Work Phone:
Cell Phone:
Age:
Email Address:
How many adults in household?
How many children?
Age(s) of children living in your home?
Who will be responsible for your cat? Daily cleaning, feeding etc.
Does your home have the following: (check all that apply)					Screens on your windows BalconyFenced Yard Pet door Sunroom Patio
Do you own or rent your home?					Own Rent
If renting, do you have your landlord's permission to keep a pet?					Yes No
Landlord's Name:
Landlord Phone:
If renting, have you paid your pet deposit?					Yes No
How long have you lived at this address?
If less than 1 year, please state how long at previous address.
Do you have plans to move within the year?					Yes No
Have you ever moved while you owned a pet?					Yes No
What did you do with the pet?
Is anyone allergic to pets in your house?					Yes No
What type of cat do you wish to adopt?  (Age, breed, sex, personality)
What are you looking for in a cat? (check all boxes that apply)					High energy Mellow or laid backIndependent Lap cat Very affectionate QuietTalkativeGreat with childrenFriend for my cat Friend for my dogFriend for me Travels well Tolerates being alone
Are you looking for a cat that will do the following? (check all that apply)					Walk on a leash Go outside in a fenced yard Be outside whenever it likesGo out on my balcony Be indoor only Stay off furniture Stay off countertops
Which of the following do you plan to use? (check all that apply)					ID tags MicrochipRegular litter boxCovered litter box Electric litter boxToilet trainScoopable litterClay litterScratching post Sticky paws Declaw HarnessLeash          CollarPet door
What bad habit will you not tolerate in a cat?
Do you realize that cats often live longer than 15 years and are you willing to accept responsibility for that long?					Yes No
What made you decide you wanted to adopt a cat today and how long have you been looking?
How did you find Little Orphan Angels?					PetFinder.com Vet referral Previous Adopter PetsMart
Can you keep your new cat isolated from existing pets for at least a week?					Yes No
Where do you have or plan to place the litter box?
Have you ever owned a cat with a litter box problem? What did you do?
What brand & type of food do you intend to feed your cat?
Where do you plan to keep the food/water bowl?
What percentage of the time will your cat be indoors?
Do you have a dog or cat door?					No Yes  to where:
Will there be any regular extended periods of time your cat will be alone?					Yes No   if yes, please describe what arrangements will be made for the cat's regular and emergency care:
Where will this cat be kept while you are at work or away from home?
Where will this cat sleep at night?
What would you do if your pet shows destructive behavior? Please be specific.
Under what circumstances have you given up a pet? Under what circumstances would you give up a pet?
Do you want to have your cat spayed or neutered?					Yes No
Do you want to have your cat declawed?					Yes No
Who is your current Veterinarian/Clinic:
Veterinarian Telephone:
Are you familiar with the following diseases?					Feline Leukemia  Feline Urological Syndrome Feline Infectious Peritonitis Feline Immunedeficient Virus
Are any cats in your household diagnosed with any of the above diseases?					Yes No   if yes, please describe:
Have you ever adopted a cat before? If so where from and when?					Yes No
Have you ever given up an animal for adoption?  If yes, why and what arrangements did you make?					Yes No
Number of pets currently owned:					Dogs:      Cats:   Others:
Please list details for all of your currently owned pets:
Cat/Dog	Breed	Age	Sex	Length of Ownership	Vaccination Due Date	Neutered	If not neutered why not?	Declawed	Percentage of time kept indoors
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Please list details for all of your previously owned pets:
Cat/Dog	Breed	Age	Sex	Length of Ownership	What became of this pet?	Neutered	If not neutered why not?	Declawed	Percentage of time kept indoors
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N
Cat Dog OTH			M F			Y N		Y N

I certify that the above information is true and that false information may result in nullifying this adoption. I also authorize my veterinarian to release my veterinary records on my personal pets.

Little Orphan Angels Animal Rescue & Adoption Agency

PMB #252, 1540 Keller Parkway, Suite 108, Keller, TX 76248 

(817) 745-2386 ۰ Fax: (817) 745-2385

A  nonprofit, tax-exempt organization

©Copy Right Little Orphan Angels Animal Rescue & Adoption Agency 2007