EmailMe Form - Hole In One Animal Rescue Cat Adoption Application

EmailMeForm

Personal information
Name of cat(s) you are interested in adopting. *
Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Home phone
### - ### - ####
Mobile phone *
### - ### - ####
Email *
How long have you lived at your current address? *
If less than two years, what was your previous address? *
Do you rent or own? *
Rent
Own
If you rent, please provide your landlord's name, address, and phone number. *
Do you have your landlord's permission to get a cat? *
Yes
No
NA
Are you aware of pet deposit and monthly fees (if required)? *
Yes
No
NA
What is your family's lifestyle like? *
Active and on the go
Quiet and relaxed
Entertain frequently
Lots of kids in and out
Travel frequently
Do you have children? *
Yes
No
If you have children, please list name(s) and age(s): *
Why have you decided to get a cat? *
What are you looking for in a pet? *
Who will be responsible for taking care of the cat? *
How many hours per day will the cat be alone? *
Where will the cat stay when no one is at home? *
Where will your cat stay when you are home? At night? *
Who will care for your cat when you are out of town (vacation, etc.)? *
Under what condition(s) would you have to give up your cat? *
Please tell us about any pets you currently have. Please provide name(s), breed, age & indicate if they have been spayed/neutered. *
If applicable, please tell us any information about any pets you have had in the last 5 years that are no longer with you: *
Current vet information (include name, address, phone number): *
Please provide three (3) references: *

Name Phone Number Years Known

Reference #1

Reference #2

Reference #3
Agreements for Adoption

Please read carefully and indicate agreement of terms and conditions.
Agreements for Adoption:
* I am prepared to make a lifetime commitment to my cat.

* I will work with my vet and agree on a regular schedule for wellness visits, inoculations, and any other tests we agree are necessary for the health and well-being of my cat.

* If, for any reason, I am unable or unwilling to keep this cat, I agree to return him/her to the Original Pet Owner. I will not give this cat away, take it to a shelter, place him/her with another person or family member, or sell this cat to any other person without the express permission of the original Pet Owner.

* I am financially able to provide routine and emergency care for this cat for his/her lifetime. This includes but is not limited to food, boarding (if necessary), and regular vet care. *
I agree to the terms of this agreement.
I agree to the $25.00 application fee and understand if my application results in an adoption from HIOAR, the fee will be deducted from the adoption fee.
Please send application fee via PayPal to holeinoneanimalrescue@yahoo.com.
By submitting this form, I confirm that all of the information I have provided is true and complete. This cat will reside in my home as a family pet. I will provide it with quality cat food, fresh water, indoor shelter, and regular veterinary care.

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	Name	Phone Number	Years Known
Reference #1
Reference #2
Reference #3

Personal information

Agreements for Adoption

I agree to the $25.00 application fee and understand if my application results in an adoption from HIOAR, the fee will be deducted from the adoption fee.

By submitting this form, I confirm that all of the information I have provided is true and complete. This cat will reside in my home as a family pet. I will provide it with quality cat food, fresh water, indoor shelter, and regular veterinary care.