Adoption Screening Form***Please allow 72 hours for us to process your application*** Name * First Name Last Name Email * Home Phone (###) ### #### Cell Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Are you 18 years of age or over? Yes No Permanent Resident of Canada: Yes No Cats/Kittens interested in (Name(s) or Descriptions i.e. black kitten, long-hair, friendly): * Have you already met this cat/kitten? If yes, please let us know at what place or event. Preferred method of contact Home Phone Cell Phone Email Residence * Own my home Owned by family Renting Type of Home Single Dwelling Home Townhouse Duplex Condo Apartment Basement Suite Other If "Other" please specify: If Renting* *Written permission provided by: Landlord Condo/Townhouse Agreement Family *Landlord Contact Information Pet Deposit? Yes No Paid Number of Pets Permitted Roommate(s) / Partner Name First Name Last Name Phone (###) ### #### Email Do you have any animal allergies? Agrees to adoption? Yes No Family How many children in the home? Ages? Have they been exposed to cats before? Yes No Do you have any animal allergies? * Does anyone else in the home have any animal allergies? * Experience owning cats? None 1-2 years All my life Current Pets Please list all pets currently in your home Include: Owned By, Species/ Breed or Description, Age, Sex, Spayed/Neutered (if not, why) Have any of your past pets been declawed? * For what reason? What veterinarian/clinic do you or have you used? * When was the date of your last vet visit? *Please note that SCAT Street Cat Rescue requires that cats receive regular annual checkups and age appropriate vaccinations unless otherwise advised by your veterinarian. Previously Owned Animals Please list previous pets you have owned Species/ Breed or Description, Age, Sex, Fixed (if no why), Why are they no longer in your care? (if they passed away what from) Finding your perfect match! Cat habits I just cannot tolerate (i.e. scratching furniture) * What will you do if this cat/kitten starts to do something you don’t like? * This cat is for: Myself My family My child Barn/Farm Gift* *If "gift" for who? The activity level in my house is usually * High Medium Low I am usually out of the house: * Most of the day During work hours Only occasionally My cat will live: * Inside only Inside & Outside Outside Only In the instance the I am unable to care for my cat any longer I would make the following arrangements * *Although cats are a lifetime commitment and we seek forever homes, we know unforeseeable things can occur that may result in the “return” of one of our cats. Please note that SCAT Street Cat Rescue’s adoption contract requires our cats to come back into our care if you are unable to care for them any longer. However, we ask our adopters to identify a trusted family member or friend who would want to either take over the adoption contract or foster the cat within our system until they can be rehomed, should something unexpected happen. Prior to rehoming, we would need to be informed and would require another screening form from the new home to update our system. Under no circumstances should a SCAT cat be given to a stranger or rehomed without contacting us first. Release I hereby give permission to SCAT Street Cat Rescue to contact anyone necessary in order to verify any information contained within this application. This may include landlords and other animal welfare agencies, as well as my veterinarian to obtain information about past and present pets. Yes No I understand that photos and/or stories of this pet may be used for success story presentations, website and/or newsletter, with the strict understanding that SCAT Street Cat Rescue will not publish any personal contact information and will not use my last name unless I give my permission. Yes No I would like to be added to a general mailing list that gives me information on SCAT Street Cat Rescue events and fundraisers Yes No Any additional comments? References Name (reference 1) * First Name Last Name Relationship to you Primary contact number * (###) ### #### Secondary contact number (###) ### #### Name (reference 2) * First Name Last Name Relationship to you Primary contact number * (###) ### #### Secondary contact number (###) ### #### Terms of Screening Application Agreement I certify that the information provided on this application if true and correct to the best of my knowledge. I understand that signature on this form is not a guarantee of adoption approval, however, if I am approved as an adopter, I agree to pay the required adoption fee in cash, cheque or e-transfer at the time of adoption. * (please check to indicate you have read and understand) Agree Do not agree Do not understand Applicant Signature: * Date MM DD YYYY Your application has been submitted! Please allow 72 hours to process due to our current office hours Monday-Friday 11am-5:30pm. Click here for the printable PDF adoption screen form
