First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Work Phone
x

Cell Phone*

Are text communications okay?

Which cat are you interested in adopting?*
Choose an animal: Daryl Puppy Small Breed Stanley

What county do you live in?*

List your occupation, employer name & address, and number of years at your current job. If unemployed, please explain how you will fund the costs of keeping the pet healthy including vetting and any boarding or other expenses.*

Please provide your vet's name and phone number.*

Please list the name and number of your local animal control.*

Please list 3 personal references (name and phone number) **Please include one neighbor and not more than one family member***

How did you hear about this pet?*

Is this cat a gift for someone?

Will the cat be kept at a different address?

Do you own or rent your home*
Choose one: Rent Own

How long at this residence?*

If you rent, have you received the approval of your landlord to have an animal*
Choose one: Yes No

Do you live in a community? If so, which one? Most communities have breed and/or weight restrictions. Please refer to your lease, if you are unsure.*

If you rent, please enter your landlord's name and phone number

Where will this cat live? (Check all that apply)

Where will the cat sleep?*

How will this cat spend it's time alone?*

How many hours/day on average will the cat be home alone?*

Do you plan on declawing this cat in the future?

What will your plan be if the cat begins to act out, refuses to use litter box, or scratches furniture? *

What will your plan be if your current pets do not accept the new cat into their home?*

If you move, are you willing to bring this cat to live with you in your new residence?

Cats can live up to 20+ years, if something should happen to you, do you have plans for the cat? *

Have you ever given a pet to a shelter?

If yes, why?

Number of adults in household?*

Number of children in household?*

Does anyone in the household have allergies to cats?

If no current allergies, what if allergies occur after adoption?*

Do you currently own any other pets?

Type/Breed/Ages*

**Following questions to be answered if you currently have pets in the home** Are your current pets spayed/neutered/up to date on shots?

Is pet UTD with all shots?

Are your current pets on monthly heartworm preventative?

Are your current pets on monthly flea/tick preventative?

Which product is used?*

Are you aware that the regular veterinarian bills can run between $100 to $500 a year?

Please list each pet you have previously owned and what happened to them?*

What times are you available for a Home Check?*

Please list any additional names (other than applicant) that should be on adoption certificate if adoption takes place. *

TLCAR has a “no refund” policy. Is this acceptable to you?

Please Initial after reading and agreeing to these terms: TLCAR believes that all pets should be indoor only pets. The animals we adopt out are never to be allowed to roam outside due to the potential hazard of getting hit/run over by vehicles, injuries from other wild or domesticated animals/spreading of disease. Initials: *

The adopter of this animal will purchase a pet carrier/crate large enough for the pet to stand up and turn around in. Initials:*

TLC ANIMAL RESCUE RESERVES THE RIGHT TO TAKE BACK ANY PET THAT IS FOUND CHAINED OR TIED UP, ABUSED OR NEGLECTED IN ANY WAY, OR NOT BEING PROPERLY CARED FOR. Initials: *

RELEASE OF LIABILITY: I, TLCAR, volunteers, foster volunteers and representatives of TLCAR from any and all claims and actions, whether it’s for property damage caused by the animal(s) or for personal injury to me, family members, any other person and any other animal (including personal pets, livestock, or other animals) from biting, scratching, transmittal of disease, and/or any other matter attributable to said animal(s). Please sign:*

MEDICAL RELEASE OF LIABILITY: TLC Animal Rescue will not be responsible for any medical bills for your pet after adoption unless arranged for at time of adoption. Please sign:*

I/We further understand and agree: 1. To return cat to TLCAR if unable to keep. To never abandon, sell, or give the cat to a shelter, breeder, or laboratory. 2. To notify TLCAR if the cat is lost or stolen and to make all reasonable efforts to locate the cat. 3. To never allow this cat to be trained for or used for protection or as an attack cat. 4. To treat this cat as a family pet with affection and kindness, never subjecting this cat to abuse or cruelty. 5. To provide regular veterinary care, including annual shots, heartworm preventative, and parasite checks. 6. To always keep this cat within a fenced yard (not on a chain), on a leash, or safely within the home. 7. To not transport this cat unconfined in an open vehicle. 8. To regularly check the tightness of any collar. To affix any licenses and tags to the collar and to never leave a choke chain on the cat when not attended. 9. To allow TLCAR to make follow-up calls and/or visits. 10. To contact TLCAR, a veterinarian, or an obedience trainer when problems arise so that the problem may be eliminated or alleviated. I/We further understand and agree that: 1. Non-compliance with any of the above terms and conditions may result in the immediate forfeiture of the cat and that TLCAR may reclaim this cat without payment of compensation to me/us. 2. TLCAR has explained the typical characteristics and temperament of the pet. 3. TLCAR has advised me/us that the cat can sometimes dig, chew, soil, and exhibit other undesirable traits unless properly supervised, confined, and trained. 4. TLCAR has given me all information necessary to make an informed decision to adopt this cat. In consideration of the adoption of this cat, I/we agree to assume full responsibility for the conduct of this cat upon the date of this contract. I/we further agree to hold harmless TLCAR, its volunteers, and any individuals associated with TLCAR and to indemnify such organizations or individuals for any damages or costs resulting from liability, known or unknown, anticipated or unanticipated, as a result of the cat's conduct after the date of this adoption contract. I have read the terms of this application and the adoption of the pet that I am applying for, and by signing below I certify that the information I gave in this application is true, and any misrepresentation of facts may result in my losing the privilege of adopting a pet through TLCAR in the future and the forfeiture of this cat or cat. Also by signing below I agree to all the terms as set forth herein by TLCAR in this application. Signature:*