Animal Aid Vermilion Area

All questions are REQUIRED to be answered.

Name

Street Address - include apartment number if applicable

City

State

Zip Code

Home Phone Number

Cell Phone Number

Email

Date of Birth/Age

Ages of others in household

Name of cat/kitten interesting in adoption. We suggest listing more than one.

Specify why you are interested in this cat.

Type of home you live in. (Mobile, Apt, House)

How long have you lived there?

Landlord Contact Info - Name & Number

Please tell us why you are interested in getting a new pet.

How long are you commited in taking care of the cat?

Please list the pets you currently own. Please seperate animals with a comma

Name: Breed: Age: Spayed/Neutered Date of vaccinations:

Please list any animals you have had in the past and the reason you no longer own them.

Current Veterinarian-Name, Address, Number

Do you plan on declawing this cat?

Yes
No

Will the cat have free roam of the home?

Yes
No

Where will your new cat live?

Inside forever
Inside until it is an adult
Inside/Outside
Outside Only
On a screened in porch/patio
A barn

Where will you keep its litter?

How do you plan on getting your new cat home?

How much do you plan on spending on the cat? (not including food)

Have you ever sold, given away, or surrendered a pet? If yes, please explain.

If you move, what will you do with your cat?

What will you do if you can no longer keep him/her?

What plans will you make for the cat during your vacation?

If you have to evacuate, where will your cat stay?

What will you do if the pet becomes very ill? How far with treatment will you go?

Have you or any member of your household ever been cited for a leash law violations or cruelty to animlas in the past? If yes, please explain.

Reference #1--Name and Number

Reference #2--Name and Number

Have you read the adoption requirements as stated above this application.

Yes
No

Please type your name below to verify all information above is true and complete. This animal will reside in your home as a pet. You will provide it with quality animal food, plenty of fresh water, indoor shelter, annual phyiscal examination and vaccinations under the supervision of a licenses veterinarian, and unconditional love and affection.