Page 1 of 13 CAT ADOPTION APPLICATION FORM Dear applicant, Please be aware that this application will be reviewed by an adoption counselor. Starfish Animal Rescue reserves the right to deny any adoption. Applicants should be prepared to present a photo ID with current address. If different, proof of current address will be necessary. Renters will need a copy of lease or verbal confirmation from landlord regarding pet policy. Condo/Townhouse owners will need to present a copy of the bylaws. NOTE: We do not adopt to homes outside of the Chicagoland area and suburbs. If you do not live in our stated adoption range please do not complete an application. Thank you for your support and interest in our animals. Starfish Animal Rescue If you are applying for a kitten, please note that we require that they be adopted in pairs or that you have a friendly cat in your home already. Names(s) of cat(s) you are interested in:* Invalid Input Today's Date* Invalid Input Next > PRIMARY ADOPTER INFORMATION Full Name:* Please type your full name. E-mail:* Invalid email address. Cell Phone Number:* Invalid Input Birthday:* Invalid Input < PrevNext > Address Information Street Address:* Invalid Input City:* Invalid Input If you live outside of the Chicagoland and Suburban area please do not complete this application. We only adopt to homes in this area. State:* Invalid Input Zip Code:* Invalid Input < PrevNext > EMPLOYMENT INFORMATION Employer:* Invalid Input Current Position:* Invalid Input Employer Phone Number* Invalid Input Full Name:* Please type your full name. E-mail* Invalid email address. Cell Phone Number:* Invalid Input Street Address:* Invalid Input City:* Invalid Input State:* Invalid Input Zip Code:* Invalid Input < PrevNext > Employment Information (Part 2) Employer:* Invalid Input Current Position:* Invalid Input Employer Phone Number* Invalid Input < PrevNext > Residence Information Number of years at residence:* Invalid Input If less than 1 year, what was your prior address? Invalid Input Type of Property:* House (Single-Detached)TownhouseApartmentCondoMobile HomeOther Invalid Input If "Other", please indicate type of property: Invalid Input Do you Own or Rent your home?* OwnRent Invalid Input If you rent- Landlord/Complex Name: Invalid Input If you rent- Landlord/Complex Phone Number: Invalid Input If you rent- Are you allowed pets? YesNo Invalid Input If you rent: Are there any pet restrictions? Please describe: Invalid Input Do you plan to move within a year and if so, where?* Invalid Input < PrevNext > Family Information Number of adults in household:* Invalid Input Ages and Relationships of Adults in Household:* Invalid Input Number of children in household:* Invalid Input Ages and Relationships of Children in Household:* Invalid Input Is anyone in your household allergic to animals?* YesNo Invalid Input If yes, who and to what type of animal. Otherwise, type NONE: Invalid Input < PrevNext > Pet Caregiving If you have to move in the future, what will you do with your pets?* Invalid Input Who in the household will be the pet's primary caregiver?* Invalid Input What are your beliefs regarding spaying/neutering?* Invalid Input Please list all the dogs and cats you have owned as an adult. NAME | BREED | AGE | SEX | NEUTERED/SPAYED | DECLAWED | LIVING/DECEASED | If no longer living with you and still alive, why and where are they If this is your very first pet as an adult, please type NONE.* Invalid Input Have you ever turned an animal in to a shelter?* YesNo Invalid Input If you have returned a pet to a shelter, please explain: Invalid Input Who is or will be your Veterinarian?* Invalid Input Veterinarian's City:* Invalid Input Veterinarian's Phone Number:* Invalid Input Are all your pets up to date on vaccinations?* Invalid Input < PrevNext > Lifestyle Information Have you adopted from Starfish Animal Rescue in the past?* YesNo Invalid Input Describe your ideal pet / Why do you want to adopt?* Invalid Input What kind of pet are you looking for?* IndoorOutdoorBoth Invalid Input Where will the pet be when you're home?* Invalid Input Where will the pet sleep at night?* Invalid Input Where will the pet be when you're NOT home?* Invalid Input What activity level would you like your pet to have?* LowMediumHigh Invalid Input How many hours a day will your pet be alone?* 0-2 hours3-6 hours7-9 hours10+ hours Invalid Input How will you entertain/exercise your pet?* Invalid Input How often will you clean your pet's litter box?* Once a daySeveral times a dayWeeklyNever - I'm teaching them to use the toilet Invalid Input How many litter boxes will be available to the pet?* 12345678910+ Invalid Input Have you ever clipped a pet's nails?* YesNo Invalid Input Will you declaw your cat?* NoYes (2 Paw)Yes (4 Paw) Invalid Input < PrevNext > Training Information How will you introduce your new pet to other animals in the household. If no other pets, type NONE:* Invalid Input How much time are you prepared to allow for your new pet to adjust to your home and other animals? If no other pets, type None:* Invalid Input < PrevNext > Pet Characteristic Information Under what circumstances would you return an animal to our rescue?* Moving across state/into apartment Lost job/can no longer affordBehavioral issues (i.e., dog aggression, etc.)Health issues (i.e., hip displasia, etc)Having kidsGets too bigAllergiesOtherNone Invalid Input If a circumstance for returning an animal to our rescue was not in the previous list, please explain: Invalid Input < PrevNext > Owner Responsibility Are you prepared to assume the financial responsibilities of providing your pet with adequate food, training, toys, routine and emergency medical care etc. (approx. $1,000+ per year)?* YesNo Invalid Input Are you committed to providing a responsible home for your pet’s entire life (could be 18+ years)?* YesNo Invalid Input How did you learn about Starfish Animal Rescue?* FacebookFriend/FamilyInternetPetcoPetfinderPrior AdopterSupporterWebsiteOther Invalid Input Are you willing to sign a legal contract agreeing to pet owner responsibility?* YesNo Invalid Input < PrevNext > Agreement I understand that Starfish Animal Rescue will only use this information to contact me to help me find a forever home for one of their pets.* YesNo Invalid Input By entering my FULL NAME and DATE below, I certify that the information provided is complete and correct. I realize that any misrepresentation of fact may result in my losing the privilege of adopting an animal. I understand that Starfish Animal Rescue has the right to deny my request for adoption. I authorize verification of all statements on this application including but not limited to prior vet medical history. I understand that this application is the property of Starfish Animal Rescue who reserves the right to share this information with other shelters and rescue organizations.* Invalid Input Digital Signature. Use Mouse or Touchscreen to sign below.* Invalid Input Are you a Robot?* Invalid Input < PrevSubmit Adoption Application
