Current Adoption Application

Full Name*

First Name Last Name
Birth Date of Applicant*

Month Day Year
Address*

Street Address
Street Address Line 2
City State / Province
Postal / Zip Code Country
How long have you lived at this address?*
Cell/Home Phone*

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail address
Do you own or rent your residence?*

ownrent
In what type of home do you live?*

HouseDuplexApartmentCondoMobile Home
If you live in a rental property, please provide your landlord's information below.
Apartment complex/landlord/management company
Landlord's Phone #

Area Code Phone Number
Note: Lack of accurate and complete landlord information will delay processing of your application. Application processing cannot be completed until your landlord provides verification of pet policies.
If less than one year at current residence, please provide your previous address:

Street Address
Street Address Line 2
City State / Province
Postal / Zip Code Country
Did you previously own or rent?

OwnedRented
Employer*
Enter employer or "n/a" if not employed
Occupation*
Is the cat for yourself?*

YesNo
If no, who is the cat for?
Are you over 19?*

YesNo
If not, please provide your parent or guardian's name

First Name Last Name
Are you a student?*

YesNo
Citizenship Status*

U.S. citizenH-1B visaF-1 visaJ-1 visa
Please list the name and birth date of all other people in your household
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Full Name

First Name Last Name
Birth Date

Month Day Year
Does anyone in the household have allergies?*

YesNo
If you move, will you take this cat with you?*

YesYes, if landlord allowsNoNot Sure
List all pets currently in your household, including any roommates' pets:
Name/Type
Color/Breed
Age
Sex
Altered?
Other (declawed, FIV, etc.)
Name/Type
Color/Breed
Age
Sex
Altered?
Other (declawed, FIV, etc.)
Name/Type
Color/Breed
Age
Sex
Altered?
Other (declawed, FIV, etc.)
Name/Type
Color/Breed
Age
Sex
Altered?
Other (declawed, FIV, etc.)
Have you had a pet, not listed above, in the past five years?*

YesNo
If Yes, please explain:
Current vet or clinic name:
When was your pet's last visit?
Purpose of visit:
Are you interested in adopting a cat or kitten?*

CatKitten
Are you interested in a specific cat at The Cat House?*
Are you interested in a particular color, breed or gender?*
If the specific cat you are interested in has been adopted, are you interested in adopting another cat?

YesNo
I want this cat to be:*

a household companiona barn cat / mousera gifta companion for other peta child's pet
This cat would be:*

exclusively indoorsprimarily indoors / outdoors occasionally during the dayindoors / outdoors as he / she wishesoutdoors with shelter
Have you turned in pets to a shelter, including The Cat House?*

yesno
If yes, what where the circumstances?
Have you ever adopted from The Cat House?*

yesno
If yes, approximate date:

Month Day Year
In a 24-hour day, the cat would be left alone:*

less than 4 hours4 to 8 hours8 to 12 hoursmore than 12 hours
If more than 12 hours, please explain:
Are you aware of your local ordinances regarding cats?*

yesno
Will this cat share a litter box?*

yesno
How many litter boxes will be provided in your home?*
Are you willing to add an additional litter box, if needed?*

yesno
If no, please explain:
Cats can take a month or longer, to adjust to a new home, particularly if other pets are involved. Are you willing to devote this much time to helping a cat become comfortable in your home?*

yesno
If adopting a kitten, who will be responsible for the socialization and training needs of a kitten four months of age or under?
A cat's lifespan may reach or exceed 20 years. Are you prepared to provide a home for a cat for that length of time?*

yesno
The annual cost of food, litter, supplies, and routine vet care for one cat may exceed $1,000; conditions may arise that increase veterinary care costs to a much higher amount. Are you financially prepared for the cost of caring for a cat?*

yesno
How would you pay a vet bill of $1,000 or more tomorrow?*
Are you considering declawing this pet?*

yesno
Which paws would you like to declaw?*

Front paws onlyAll paws
Please explain why you would like to declaw this cat:*
Would you be willing to allow a representative of The Cat House to visit your residence by appointment?*

yesno
Have you, or any member of the household, ever been convicted of a felony?*

yesno
Have you, or any member of the household, ever been convicted of an animal-related misdemeanor or violation?*

yesno
Please explain any felony or animal-related convictions:
Where did you hear about The Cat House?*
The Cat House limits pet adoptions to within a 200 mile radius of Lincoln, NE. We do not ship animals nor do we do any type of long distance adoptions. We do not adopt to persons under 19 years of age. We require prospective adopters to meet both us and the animal, fill out an application and be interviewed. Adoptions are not done a first-come, first-served basis. Applicants are selected based upon the best match of the particular pet's temperament and needs. If an application is approved we may require a home check by our volunteers to ensure the cat's safety. These pets are not for sale and the decision of where to place them is solely the responsibility of The Cat House. We reserve the right to refuse placement of our pets to any individual who does not meet our criteria. We also reserve the right to keep our reasons for refusal confidential within our organization. The welfare of our rescue animals is our top priority.
Acknowledgment*

By checking here, you agree that you have read the above policy
Each cat or kitten at The Cat House has been tested for feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV), and vaccinated against rabies and distemper/upper respiratory infections, is spayed or neutered, microchipped, and has been seen by a vet and received a physical exam.

Our adoption fees are:

Adult cats, age eight months through six years: $80
Mature cats, age seven years or older: $60
Kittens, through seven months old: $100

The adoption fee is reduced to $60 for cats or kittens of any age if you are 60 years or older. If you adopt a second cat or kitten within three months, the fee is half of the usual amount.
By clicking the submit button below, I certify that I have answered all questions truthfully, and I understand that if any intentional false statements have been given this application and any subsequent adoption may be voided.
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