LPC Cat Adoption Application

PLEASE NOTE: Completing this application is merely the first step towards adopting a cat. By submitting this completed application, you are neither guaranteed nor obligated to adopt. This is merely the beginning of a process that will include vet references, phone interviews and, on occasion, home visits. This application is designed to help us make the best placement possible. The adoption process takes time because we are committed to giving you all the information and support you need to have a successful adoption experience. We ask you for your patience and cooperation in the joyful process of bringing people and animals together.

Which pet are you interested in	*
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Date	*
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First Name	*
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Last Name	*
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Phone #	*
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Email	*
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Best Time to call	*
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Street Address	*
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City	*
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State	*
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Zip	*
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Mailing Address	*
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Mailing City	*
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Mailing State	*
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Mailing Zip	*
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Employer	*
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Occupation	*
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Spouse's First Name	*
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Spouse's Last Name	*
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Spouse's Employer	*
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Spouse's Occupation	*
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Where Do You Live?	*
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How Long Have You Lived at Present Address?	*
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Do You Rent or Own?	*
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If Renting, Landlord's Name	*
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Landlord's Phone	*
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If You Move, What Will You Do With This Pet?	*
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Where will this pet be kept during the day?	*
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Where will this pet be kept during the night?	*
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Where will this pet be kept when no one is home?	*
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Where will the pet be kept when you're on vacation?	*
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Who will be responsible for this pet?	*
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Is anyone in the house allergic to cats?	*
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Vet Clinic Name/Reference	*
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Vet Address	*
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Vet Phone	*
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Personal Reference #1 Name	*
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Reference #1 Phone	*
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Personal Reference #2 Name	*
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Reference #2 Phone	*
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Please list all pets owned in the last 5 years. Include their names, breeds, ages, how long owned, where they were kept (in/out) and whether they were spayed/neutered.	*
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What happened to these animals	*
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Please list type, breed, age, gender, where kept and if spayed/neutered for all animals currently living in the home.	*
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What will you do to help this animal adjust to your current animals?	*
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Have you adopted from the Lander Pet Connection before?	*
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What Happened to This/These Animal(s)?	*
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If your animal were to get lost what will you do to find him/her?	*
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If you no longer want to keep this animal what will you do?	*
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What will you do if your pet shows destructive behavior?	*
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Have your cats been tested for feline leukemia?	*
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Have your cats been tested for FIV?	*
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(Please initial) I understand that the Lander Pet Connection does not test for feline leukemia or FIV. I will consult with my veterinarian for advice prior to adopting any cat from LPC in regards to feline leukemia and FIV.	*
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Why do you want this cat (check all that apply)	*
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If you answered "other" above, please explain here	*
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If you have lost a pet or it died at an early age or due to an accident, please provide details	*
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If you have ever put a pet to sleep, please provide details	*
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If you have ever surrendered a pet to a shelter or rescue group please provide details	*
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How much money do you plan on spending on this pet each year (food, vet, boarding, toys, etc.)?	*
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Describe your reason for wanting to adopt this pet	*
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Would you be willing to accept a pet with some health problems	*
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Would you be willing to accept an animal that is not housetrained?	*
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Would you be willing to accept a cat with some behavior problems?	*
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Would you consider adopting a senior pet?	*
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Describe the size, sex, color and personality of the pet you prefer to adopt	*
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Please list the name, age and relationship of persons living in house (including yourself)	*
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If no children are listed above, are there plans for children in the future?	*
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If yes, what will you do with this animal in the event you have children?	*
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Have you filled out adoption applications at other shelter?	*
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Comments	*
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(Please initial if agreed) Most shelter animals have unknown medical backgrounds. Are you prepared to take your new pet for a complete veterinary exam within 2 weeks of adoption and provide the necessary treatment, if needed?	*
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(Please initial) By submitting this form you are certifying that all information contained above is true and correct. That you are over 18 years of age and the person responsible for making pet decisions in your family. That you are looking to adopt a pet, give it a good and loving home as a pet owner and accept full responsibility for his/her care. I also understand that failure to comply with conditions set forth in the adoption contract could result in the refusal of future adoptions from the Lander Pet Connection.	*
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(Please initial) I agree to abide by all state and local pet control laws. I understand it is my responsibility to become familiar with these laws.	*
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(Please initial) Returning the Animal: If, for any reason this adoption is not satisfactory to the adopting party or if the adopters fail to comply with the terms of the adoption at any time during the next six months, the pet must be returned to the Lander Pet Connection. It may not be given away or sold to anyone else without the prior permission of LPC, nor can it be released to a shelter or pound	*
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(Please initial) Reservation of Rights: Lander Pet Connection reserves the right to arrange a follow up visit and to ascertain if all conditions of this adoption are being upheld. Should any term or condition of this agreement not be upheld, the Lander Pet Connection reserves the right to terminate this agreement and the pet must be returned to the program.	*
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(Please initial) Release of LPC of Damage: I, the undersigned, understand that taking an adopted animal into my household carries with it certain risks. I will not hold the Lander Pet Connection liable for any physical or psychological damage that this animal may create.	*
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(Please initial) Un-Altered Animals: I understand that pet overpopulation is a problem in our community and will should the animal I adopt be unaltered, that an additional refundable deposit of $25 for cats will be required. This deposit will be refunded upon providing proof of spay/neuter for the adopted pet. The deposit will be held for 30 days to allow sufficient time to have your animal properly altered.	*
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(Please initial) The adopter has read the above disclosures and agrees to the terms of this Adoption Agreement	*
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Signature of Potential Adopter	*
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Our adoption committee will review the application and if additional information is required you will be contacted. Thank you for your interest in saving a life!