APPLICATION FOR CAT ADOPTION

ADOPTIONS ONLY WITHIN A 100 MILE RADIUS OF THE

INDEPENDENCE/KCMO AREA

Veterinarian Reference Showing a History of Good Pet Ownership, including a minimum of FIVE years consecutive vet history to include yearly vaccines is REQUIRED.

You must be 21 or older

Please list name and age for yourself and all occupants of your home:

Street Address / City / State / Zip:

Daytime Phone:

Evening Phone:

Email Address:

Ownership

Own

Rent

If you rent or lease, list the name and phone number of the landlord or property owner:

Where will your cat be kept most of the time:

Inside the house, where would your cat be kept most of the time:

Name & Age of Pet (Pet #1)

Type of Pet / Spayed or Neutered

Is your pet current on vaccinations?

Yes

No

Name & Age of Pet (Pet #2)

Type of Pet / Spayed or Neutered

Is your pet current on vaccinations?

Yes

No

Name & Age of Pet (Pet #3)

Type of Pet / Spayed or Neutered

Is your pet current on vaccinations?

Yes

No

Name & Age of Pet (Pet #4)

Type of Pet / Spayed or Neutered

Is your pet current on vaccinations?

Yes

No

Present Veterinarian / Clinic Name:

Street Address / City / State / Zip:

Phone Number:

Previous Veterinarian / Clinic Name:

Street Address / City / State / Zip:

Phone Number:

If you have owned other dogs / cats, and do not now, what happened to them? (Disease / illness / ran away)

If you have ever had to give a dog / cat up, what was the circumstance?

What would you do, if for any reason (moving, health issue, etc.), you can no longer care for your pet?

Check any of the following you feel are valid reasons for giving away a pet:

Name of the animal(s) you are interested in and if you want to FOSTER or ADOPT:

What type of personality are you looking for (active, playful, lap cat):

Are you aware that cats can have a lifespan of up to 20 years of age?

Do you agree to return the animal to ABF if for any reason during it's lifetime you can no longer care for it:

How did you hear about us?

If Referral by Friend - Name:

A home visit is required. When would that be convenient?

I authorize ABF to check my veterinarian reference:

I understand that if my application is selected, I will be contacted by phone withing 5 business days. If I am not contacted within that time, I understand that other applicants are being pursued.:

Date

Month

Day

Year

Signature:

ABF retains the right to refuse any application. By checking this box and/or signing this form, I acknowledge and agree to accept all terms and conditions herein.

I agree

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APPLICATION FOR CAT ADOPTION