Adoption Application

Cast Aside To Survive (C.A.T.S.)

Adoption Application

$150.00 for one/$225.00 for two/includes preventatives, kitten series vaccines, rabies and spay/neuter

APPLICANT INFO

* Indicates required field

Name *

First

Last

Date *

Address *

City *

State *

Zip: *

Home Phone *

Cell Phone *

Texts ? *

Email Address: *

Date of birth *

Driver's License *

I am interested in adopting: (Kitten Name) *

REFERENCES

Reference's Name *

Relationship *

Phone *

Reference's Name *

Relationship *

Phone *

Reference's Name *

Relationship *

Phone *

ADDITIONAL INFORMATION

What pets do you currently have living in your home? Pets name(s): *

What kind of pet/animal currently living in your home? *

If you currently have pets, provide Veterinarian Name and Phone: *

Please grant permission to the vet so we may speak with them.

Are your pet(s) spayed/neutered? *

Yes No

Up to date with vaccinations? *

Yes No

Treated regularly for fleas/ticks? *

Yes No

Own/Rent home? *

Own Rent

If renting provide landlords name and phone number and advise that we will be contacting for clearance. *

Applicant's Consent *

All personal information on this form shall be maintained for internal use only and shall not be distributed to external agencies except as required by law. I certify that my answers are true and complete to the best of my knowledge.

Electronic Signature *

Date Signed *

C.A.T.S., PO Box 116, Rosendale, NY 12472 | 845-389-1178 | [email protected]

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