Adoption Application - Stray H.E.L.P.

Fields marked with an asterisk (*) are required fields.

Adopter Information

Name*

Date*

Address*

Cell Phone*

Home Phone

Email*

Date of Birth*

What is your current employment status?*

Name of Employer (if applicable)*

Work phone

How long have you been employed here?

Why are you choosing to bring a cat/kitten into your home at this time?*

If this adoption is a gift, who is the recipient?

Are they aware they are receiving this gift?

Yes
No

With regard to your home, do you*

Own
Rent
Live with family

Does the lease allow pets if you rent? Is the homeowner aware you are looking to adopt if you live with family?

Yes
No

How long have you been at your current address?*

Less than 1 year
1-4 years
5-10 years
More than 10 years

Previous Address

Please include your previous address and landlord information if you have been at your current residence for less than one year.

Street Address Address Line 2 City State ZIP Code

Landlord's name

Landlord's phone

Are you committed to take this animal with you if you relocate?*

Yes
No

Are you willing to give your new location information to Stray HELP?*

Yes
No

An average lifespan for a cat is 15-20 years. Are you fiscally responsible and willing to care for this animal for the rest of its life?*

Yes
No

How did you hear about us?*

Current/Previous Pets

Have you ever adopted from a shelter or rescue?*

Yes
No

What is the name of the shelter/rescue?

When did you adopt this pet?

Have you ever had to give up a pet?*

Yes
No

Why?

Where is that pet now?

If the pet died, how did it die?

Do you have any pets now?*

Yes
No

What type of pet (dog, cat, etc.) do you have and how many?

Do the animals currently living in your home have experience with cats?

Yes
No

What has that experience been like?

Are your current pets spayed or neutered?

Yes
No

If no, please explain circumstances:

Are your current pets up-to-date on all tests and vaccinations?

Yes
No

If your pet is a cat, has it been tested for FIV and FeLV?*

Yes
No
Not sure
My pet is not a cat

What were the results?

If you own a cat(s), is that cat(s)

Indoor only
Indoor/outdoor (including leash, stroller, deck, balcony)
Outdoor only

Have any of the cats you own, or previously owned, been declawed?*

Yes
No
Never owned a cat

Do you plan to declaw this cat?*

Yes
No

Why or why not?*

Household

How many children are in your household?*

Ages of children?

I live in a home that is*

Very active
Somewhat active
Occasionally active
Somewhat quiet
Very quiet

I am home*

Rarely
Some of the time
About half the time
Most of the time
Almost always

My experience level with cats is:*

Very experienced
Experienced in the past, but not lately
Somewhat experienced, but I have some things to learn
I’m new to living with cats

Who will be primarily responsible for the care of your new pet? This includes feeding, grooming, exercise, humane treatment, health care and finances?*

(On average, pet owners spend more than $800 per year to care for their pet.)

Do you, or does anyone in your household smoke inside the house?*

Yes
No

Does anyone in the family or household have animal allergies or asthma?*

Yes
No

If/when you travel, how do you intend to provide care for your cat while you’re away?*

What will you do if your cat exhibits problem behavior: inappropriate urination, scratching the furniture, or other destructive behavior?*

Cat/Kitten Information

Name of Cat or Kitten (If not known yet, enter TBD)*

Will this cat be:*

Indoor only
Outdoors only
Indoors and Outdoors

Why?*

Age range of feline I'm looking for:*

I am looking for a*

Needy cat
Somewhat needy cat
Somewhat independent cat
Mostly independent cat

Veterinarian

Please provide the name of the veterinarian that would have records on your past or current pets:

Vet's Phone

Please provide the last name and the pet’s name the vet record is listed under.

We verify animal records. Please call the office and give them permission to speak to us.

Do you plan to use this vet for your new pet?

Yes
No
Not sure

References

Please call all references you have listed and give them permission to speak to us.

Reference #1*

(Name, Number, Relationship)

Reference #2*

(Name, Number, Relationship)

Reference #3*

(Name, Number, Relationship)

By typing my name below, I certify the above information is accurate and complete to the best of my knowledge. I understand that Stray HELP has the right to reclaim the animal if any given information is found to be false. Also, any false statements I make may be considered a breach of the adoption application and will be denied. I authorize the release of Veterinarian information related to my current and past pets.

Comments

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