Adoption Application

Thank you for choosing to adopt a cat or kitten...or dog!

Please complete this form and we will help find the right cat(s) or kitten(s) or dog(s) for you.

We will provide information on the commitment of adopting the cat, kitten, or dog.

Applicant's Information

Email Address

Send me email updates & action alerts to help save cats' lives

Salutation

First Name

Last Name

Suffix

Primary Phone Number Format: ##########	Is this a mobile phone? mobile phone
Secondary Phone Number Format: ##########	Is this a mobile phone? mobile phone

Mailing Country

Mailing Street

House number and street name

Mailing City

Mailing State

Mailing Postal Code

How did you hear about us?

Are you under the age of 18?

Legal Guardian’s First Name

Legal Guardian’s Last Name

Legal Guardian's Email Address

Legal Guardian's Phone Number

Format: ###-###-####

Employment Information

Employer's Name

Employer's Address

Employer's Phone

Emergency Contact Information

Emergency Contact's Name

Relationship to Contact

Contact's Phone

Personal References

Reference #1

Full Name

Relation to applicant

Phone

Reference #2

Full Name

Relation to Applicant

Phone

Applicant's Household Information

In addition to yourself, are there other adults in your household?

Total number of adults in household (including yourself)

Are there any children in your household?

Total number of children in household?

Do you rent/own/other?

Landlord / Rental Information

Landlord's Name

Landlord's Phone Number

Format: ##########

Please attach a copy of your landlord's policy on pets. For example, a copy of the pet policy from your lease...

Other occupancy status, please explain...

Do you live in an...

Other residence type, please explain...

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By signing below, I/we acknowledge that all information on this form is true and correct. I/we understand that any misrepresentation of fact may result in Alley Cat Allies refusing adoption privileges to me/us. I/we authorize Alley Cat Allies to contact all veterinarians listed on the application, all references listed, and the landlord if applicable. If my/our request for adoption is approved and later Alley Cat Allies discovers the above information is not true or correct, Alley Cat Allies reserves the right to remove the adopted cat(s)/kitten(s) from my home.

Signature:	Date:
Signature:	Date:

Adopt A Cat. Change A Life.

Adoption Application