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Adoption Application

Instructions:

1) Please print neatly and clearly and circle answers
2) Provide required information, missing information will delay your application.
3) All references must be contacted before you can adopt.

PLEASE NOTE:

We do not run adoptions on a “first come, first served” basis, we try to find the best home for each cat.

Chance At Life Cat Rescue is an all-volunteer, non-profit organization. The adoption fee covers our veterinarian bills and care for the rescued cats. The fee is NON-REFUNDABLE, and to be paid at the time of adoption, no exceptions. We reserve the right to refuse any adoption that we feel is not in the best interest of the cat, or the adopter.

Section 1 – Personal Information
Date: {field:date_1705791535648} Volunteer Assisting: {field:volunteer_assisting_1705791521507}

What type of cat are you seeking to adopt? {field:what_type_of_cat_are_you_seeking_to_adopt_1705791628186}

First Name: {field:firstname} Middle Name: {field:middle_name_1705791790684} Last Name:{field:lastname}

Street Name & Number: {field:address_1705791835241} City: {field:city_1705791844708} State/Zip: {field:liststate_1705791848340} {field:zip_1705791849316}

Daytime Phone #: {field:daytime_phone_1705792365300} Cell Phone #: {field:cell_phone_1705792387229} Evening Phone #: {field:evening_phone_1705792400369}
E-mail Address: {field:email}

Section 2 – Tell Us About You!

1. How did you hear about Chance At Life Cat Rescue?{field:1_how_did_you_hear_about_chance_at_life_cat_rescue_1705792647043}

2. What type of house do you live in? {field:2_what_type_of_house_do_you_live_in_1705792801080}

3. Do you: {field:3_do_you_1705793829432}

If renting, Landlord’s name & phone: {field:if_renting_landlord_s_name_and_phone_1705794207109}

4. Make up of household (# of people) {field:adults_1705794375796} Adults {field:children_1705794387169} Children Ages of Children: {field:children_s_ages_1705794559851}

5. Do any of the persons listed above have allergies? {field:5_do_any_of_the_persons_listed_above_have_allergies_1705794679205}

6. What is your reason for wanting a cat? {field:6_what_is_your_reason_for_wanting_a_cat_1705794829049}

7. Will this be your first cat? {field:7_will_this_be_your_first_cat_1705794918915}

8. How much are you prepared to spend for routine/emergency medical care, licensing, etc.? {field:8_how_much_are_you_prepared_to_spend_for_routine_emergency_medical_care_licensing_etc_1705794976892}

9. Which family member will have the major pet care responsibility? {field:9_which_family_member_will_have_the_major_pet_care_responsibility_1706303485819}

10. Do you currently have any other pets? {field:10_do_you_currently_have_any_other_pets_1706307453101}
{field:list_pets_1706304808706}

11. Is a change in residence possible within the next few years? {field:11_is_a_change_in_residence_possible_within_the_next_few_years_1706307468058}

12. If you were moving to a residence that did not allow cats, to whom would you give the cat? {field:12_if_you_were_moving_to_a_residence_that_did_not_allow_cats_to_whom_would_you_give_the_cat_1706307474161}

13. Who is your current or previous veterinarian? Name & phone # (include name of pet and last name records are under): {field:13_who_is_your_current_or_previous_veterinarian_name_and_phone_include_name_of_pet_and_last_name_records_are_under_1706307483170}

14. If adopting a kitten, where will the kitten be kept when alone? {field:14_if_adopting_a_kitten_where_will_your_new_cat_kitten_be_kept_while_acclimating_to_its_new_environment_1706400924634}

15. Where will the cat sleep at night? {field:15_where_will_the_cat_sleep_at_night_1706307496814}

16. How many hours a day will the cat spend: Indoors {field:of_hours_indoors_1706305076678} # of hours Outdoors {field:of_hours_outdoors_1706305093472} # of hours

17. Where do you primarily plan to keep the cat? {field:17_where_do_you_primarily_plan_to_keep_the_cat_1706307537162}

18. Do you plan on declawing the cat? {field:18_do_you_plan_on_declawing_the_cat_1706305259514}

19. If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching, etc.) how would you go about correcting the behavior? {field:19_if_your_cat_displays_behavioral_problems_such_as_poor_litter_box_habits_inappropriate_scratching_etc_how_would_you_go_about_correcting_the_behavior_1706305314707}

19a. What type of solution would you be willing to try if litter box accidents continue after the first week? {field:19a_what_type_of_solution_would_you_be_willing_to_try_if_litter_box_accidents_continue_after_the_first_week_check_all_that_apply_1706305444903}

20. Some pets may take 30 days or more to adjust. Are you willing to give this pet time to adapt to its new environment and family members? {field:20_some_pets_may_take_30_days_or_more_to_adjust_are_you_willing_to_give_this_pet_time_to_adapt_to_its_new_environment_and_family_members_1706305499050}

21. Have you ever lost or given away a pet? {field:21_have_you_ever_lost_or_given_away_a_pet_1706305542873}

If Yes, please explain: {field:if_yes_please_explain_1706305589582}

22. Have you ever had a pet killed by a vehicle? {field:22_have_you_ever_had_a_pet_killed_by_a_vehicle_1706305649482}

If Yes, please explain: {field:if_yes_please_explain_1708296722690}

23. Please describe the typical work schedule of the person taking care of the cat: (i.e., work from home, work M-F, 9-5): {field:23_please_describe_the_typical_work_schedule_of_the_person_taking_care_of_the_cat_i_e_work_from_home_work_m-f_9-5_1706305698996}

Section 3 – Our Information
24. Do you understand that there is a non-refundable adoption fee to help cover the expenses of spay/neuter surgery, inoculations and general care for the cats? {field:24_do_you_understand_that_there_is_a_non-refundable_adoption_fee_to_help_cover_the_expenses_of_spay_neuter_surgery_inoculations_and_general_care_for_the_cats_1706305754808}

25. If requested, are you willing to provide written proof that your current pet is spayed/neutered? {field:25_if_requested_are_you_willing_to_provide_written_proof_that_your_current_pet_is_spayed_neutered_1706305803913}

If no, please explain: {field:if_no_please_explain_1706305857637}

26. Do you fully understand and agree, under Chance At Life Cat Rescue contract rules; the cat you are seeking to adopt will be spayed/neutered? {field:26_do_you_fully_understand_and_agree_under_chance_at_life_cat_rescue_contract_rules_the_cat_you_are_seeking_to_adopt_will_be_spayed_neutered_1706305898955}

27. If you are adopting a cat/kitten that has not been altered, are you willing to send a copy of the spay/neuter certificate to Chance At Life Cat Rescue once the procedure is completed? {field:27_if_you_are_adopting_a_cat_kitten_that_has_not_been_altered_are_you_willing_to_send_a_copy_of_the_spay_neuter_certificate_to_chance_at_life_cat_rescue_once_the_procedure_is_completed_1706305942322}

28. Do you fully understand that if you qualify and adopt a pet from Chance At Life Cat Rescue, you WILL be contacted for further verification of the cat’s welfare and will cooperate by providing requested information which MAY include a visit to your home by Chance At Life Cat Rescue? {field:28_do_you_fully_understand_that_if_you_qualify_and_adopt_a_pet_from_chance_at_life_cat_rescue_you_will_be_contacted_for_further_verification_of_the_cat_s_welfare_and_will_cooperate_by_providing_requested_information_which_may_include_a_visit_to_your_home_by_chance_at_life_cat_rescue_1706305978867}

29. Do you fully understand and agree that if your adopted cat should not work out in your home, that under Chance At Life Cat Rescue contract rules, the cat must be returned to Chance At Life Cat Rescue? {field:29_do_you_fully_understand_and_agree_that_if_your_adopted_cat_should_not_work_out_in_your_home_that_under_chance_at_life_cat_rescue_contract_rules_the_cat_must_be_returned_to_chance_at_life_cat_rescue_1706306016555}

30. In the event that you qualify and adopt a cat from Chance At Life Cat Rescue, are you willing to provide us with written follow-up reports, if requested? {field:30_in_the_event_that_you_qualify_and_adopt_a_cat_from_chance_at_life_cat_rescue_are_you_willing_to_provide_us_with_written_follow-up_reports_if_requested_1706306058633}

31. Do you fully understand that Chance At Life Cat Rescue reserves the right to refuse any adoption that we feel is not in the best interests of the cat or the adopter? {field:31_do_you_fully_understand_that_chance_at_life_cat_rescue_reserves_the_right_to_refuse_any_adoption_that_we_feel_is_not_in_the_best_interests_of_the_cat_or_the_adopter_1706306086168}

Section 4 – References
Please provide three (3) references. These references MUST NOT be related to you, NOR SHOULD THEY RESIDE WITH YOU. All references MUST be contacted BEFORE you can qualify for adoption.
{field:references_1706306330686}

{field:agreement_1706307138342} By checking this box I acknowledge that the information I provided in this application is true and correct to the best of my knowledge. I authorize Chance at Life Cat Rescue to check all references listed above. I am aware that I need to update Chance At Life Cat Rescue immediately should any of my information change.

APPLICANTS ELECTRONIC SIGNATURE. Please indicate you agree by entering your full legal name below: *
{field:applicants_electronic_signature_please_indicate_you_agree_by_entering_your_full_legal_name_below_1706307297388}

Chance at Life Cat Rescue Vanessa Staiger, President: (201) 982-2219
P.O. Box 4093
River Edge, NJ 07661-4093
Website: www.chanceatlifecatrescue.com
Email: chanceatliferescue@gmail.com