Adoption Form Step 1 of 333%Applicant Contact InformationName First Last Are you over 18? Yes NoAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country PhoneEmail Spouse/Partner Name First Last Spouse/Partner Phone #Best Time to Reach You?Alternate Phone#OccupationSpouse/Partner OccupationApplicant InformationHow many people reside in your household?Does anyone have allergies to pets? Yes NoDoes this include children? Yes NoIf yes, please list their age(s):Do you have any other pets in the house? Yes NoIf yes, please list type, breed, and age of each:Other Pet(s)Other Pet(s)Has your family owned a cat before? Yes NoIf yes, how recently?How would you best describe your living situation?HouseApartmentSharedCondoLiving with ParentsOtherDoes your property management/landlord allow pets in your residence? Yes No UnsureHow many hours would the pet be left unattended in the home?WeekdaysWeekendsWhen no one is home, where will the cat be kept?Is everyone in the household in agreement with the cat adoption? Yes NoWill your pet be allowed outdoors? Yes NoIf yes: Directly Supervised UnsupervisedAdoption InformationDo you know which cat you are interested in? Yes NoName of cat:If no, what type of cat are you looking for? Please select all that apply.Age: Kitten Adult SeniorType: Long Hair Short HairSex: Male Female EitherWhy have you decided to adopt a cat?Are you financially able and willing to provide for a cat, including annual vet check-ups, vaccinations, and necessary medical care? Yes NoEstimated Costs:Annual Exam & Vaccinations - $157.00 (approx.)Spay or neuter - $500.00 (approx.)Bloodwork - $200.00Dental Work or Surgery - $600-$1400 (approx.)Sick Cat Diagnostics - $600.00 and above (approx.)The adoption of a cat is a lifetime personal and financial commitment. Cats can live to be 16 years and often older, are you prepared for a lifetime commitment such as this? Yes NoDo you have a veterinarian that you use regularly? Yes NoVet Clinic NamePhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Please provide three personal references:Name First Last RelationshipPhoneName First Last RelationshipPhoneName First Last RelationshipPhoneWe do our best to act within the best interest of the cats that we adopt out. We expect our cats to go to a forever home that can provide them with the best of care throughout his/her life. We ask that our cats are kept up-to-date with vaccinations and vet visits, and that no cat is to be transferred to another home without the consent of Guildcrest Cat Hospital management. We ask that you please notify your veterinarian to give Guildcrest Cat Hospital permission to speak with them regarding your pets. All adoptive parents must agree to comply with follow-up calls, strictly to ensure the well-being of the cat.By signing this form I/we acknowledge that the above information is true and correct, and that I understand all aspects outlined in this application. I/we understand that any misrepresentation of fact my result in the refusal of adoption privileges by Guildcrest Cat Hospital. Date SignaturePlease provide your full name.
