Kentucky Kitty Cats Adoption Form

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

Select the name of the animal you are interested in adopting.
Choose an animal: Ash Astro Batman BooBerry Brooke Chewbacca (Sam) Chili Chilly Willy Chloe Church Cricket Duke Ebony Eggnog Frosty Fun Dip Gaia Garrett (Cheetos) Glory Gourd Grasshopper Iris Jack Jones cat 2 (chubbs) Kitler Lola Lulu Lyric M&Ms Maple Mars Merlin Milky Way Nicole Nona Pixie Poppy Princess Leia Quincy Robin Rudy Saffron Sidney Sienna Smokey Sophia Sully Taco Thor Tina Marie Ura Venus Violet Wei Jie

If not known, please describe any preferences with age, color, sex, etc..

Spouse/Partner's Name

Spouse/Partner's Phone Number:

Is your spouse/domestic partner on board with this application?*
Choose one: Yes No Ify N/A

Are you at least 18 years of age? *
Choose one: Yes No Turning 18 in the next 3 months

Do you have children living at home? If yes, list their names and ages.*

Why do you want to adopt this pet? How do you expect this cat/dog to change your home?*

Have you ever owned the species (cat/dog) of animal you are applying for? If yes, for how long? *

Have you ever given up a pet? If yes, how long ago and why?*

Do you have any pets currently? If yes, please list the name, breed/type, age, sex, and whether spayed/neutered.*

Do you any of your pets have special needs, and if so explain.

Your veterinarians name and number:*

What type of area do you live in?*
Choose one: Rural Urban Suburban

Describe your living arrangements... are you in a house, apartment, or mobile home? Do you own or rent? Do you live with other people or have extra people living in your home? If you rent, does your landlord allow animals? Is there an extra fee for the animals included in your lease?*

If renting, what is your landlord's name and number?

If renting, are pets allowed? And is there an additional fee?

How long have you lived at this residence? *

Will your adopted animal live inside or outside the home or a mixture of both? Why?*

Do you plan to offer can food?

Where will your pet be kept when no one is home?*

On average, how many hours a day will your adopted pet be alone?*

If adopting a cat, do you plan to declaw your cat?*
Choose one: Yes No Maybe I am not sure what that mean. I am applying for a dog.

Due to the fact that some kitties have allergies, please be honest as if anyone in the home smokes cigarettes?*
Choose one: Yes No A frequent visitor does

Please check any reasons that would cause you to relinquish your cat:

If other, explain:

What would happen if a family member or friend were to develop allergies?*

Are you willing to let us visit you at home during or after the adoption?*
Choose one: Yes No Maybe

Do you agree to notify Kentucky Kitty Cats if you can no longer care for your pet?*
Choose one: Yes No

By submitting this application, I certify that: (1) The information I have given is accurate, (2) I understand that Kentucky Kitty Cats have the right to deny an application, (3) I give permission for Kentucky Kitty Cats to call the housing reference and vet practices I have listed. (4) If I adopt this pet, I agree to return the pet to Kentucky Kitty Cats if I can no longer keep it, or feel it needs to be declawed or debarked because neither are allowed. (5) I understand that accidental animal bites or other injuries to humans and other animals do occur, and I agree to hold harmless and indemnify, and protect Kentucky Kitty Cats, Inc., from any claim or suit filed by anyone as a result of such an incident. In addition, Kentucky Kitty Cats, Inc. will not be responsible if the animal should damage or destroy property belonging to me or others, or shall transfer any disease or internal or external parasites to other animals belonging to me or other animals. I agree that due to the fact that lawsuits are costly and disadvantageous to both parties, the undersigned parties agree to submit to non-binding mediation to resolve any controversy between the parties, including but not limited to, claims for bodily injury, professional negligence, personal injury, breach of an express or implied. If an adoption occurs based on false information provided on this document, Kentucky Kitty Cats reserves the rights to reverse the adoption and take possession of the animal. *