Adoption Form

SAFER Adoption Form

SUBMISSION:

Please print out the form below answering all the questions. Once completed, you can mail it to SAFER, PO Box 1531, Hampton, NH 03843-1531 or fax the completed form to: SAFER, fax # 603 964 -8348. If you prefer to email us the completed form, please select the text, drop the selected text into an email message and email us at [email protected] PLEASE REMEMBER TO ANSWER ALL THE QUESTIONS. Thank you! We will contact you shortly.

SAFER Adoption Policy No cats\ kittens can be adopted without an application. If you fail to complete the entire application it will slow down the adoption process. We want to be sure our kitties are going to responsible pet owners! Approval depends on how long it takes to verify your information. The process usually takes 3-7 days, provided all information is accurate. The adoption fee is $75 per cat\ kitten or $125 for two cats. The adoption fee covers testing for feline aids, feline leukemia, spaying\ neutering, rabies and distemper vaccines.

Adoption Application (Please answer all questions completely and legibly.)

Name of applicant:___________________________________Date:___/___/___

Street address:____________________________________________________ City:_______________________State:_________________

Zip Code:_________

Daytime Tel. No. (____)____________Evening Tel. No.(____)_______________

Mailing/Summer Address (if different from above):_________________________

_________________________________________________________________

Residency Check: (Driver’s License) State_________Number________________

Exp. Date___________ DOB:____/____/____

Social Sec.___________________

1. Who is the adopted cat for?______________________________________

2. Who will be responsible for the care of the adopted cat?__________________

3. Do you have any preference as to sex, age, length of fur, etc? YES / NO Please explain;_____________________________________________________

_________________________________________________________________

4. Is this your first time owning a pet? YES \ NO

5. Why are you looking for a cat? Family Pet_____ Companion for other pets_______Barn Cat ______ Mouser ____________________________Other

6. Have you ever owned a cat before? YES \ NO

7. Do you currently have pets? If yes, please list below. Pet name / Pet type / Age / Spayed\ Neutered? / Indoor\ Outdoor / For how long? 1.__________________________________________________________________________________ 2.__________________________________________________________________________________ 3.__________________________________________________________________________________

8. How many other pets have you had in the last 5 years? Please list below. Pet name / Pet type / Age / Spayed\ Neutered? / Indoor\ Outdoor / For how long? 1.__________________________________________________________________________________ 2.__________________________________________________________________________________ 3.__________________________________________________________________________________

9. Where are the above mentioned pets now?_____________________

10. Any other relevant/important information? ____________________________________________________

______________________________________________________________

11. Is/Are your dog(s) accustomed to cats? YES / NO / N/A

12. Will this cat be strictly indoor____ strictly outdoor____ both?____

13. If strictly outdoors, or both, what assurance is there that this cat will be safe and have proper shelter from predators, traffic and inclement weather?_______________________ _______________________________________________________________________ _______________________________________________________________________ 14. How many hours a day will this cat be without human companionship?____________

15. Where will this cat be kept during this time?_________________________________

16. Are you planning to have the cat declawed? YES / NO

If YES, why?__________

17. Who is your present veterinarian?______________________ and how long have you been with him/her?________________ Please list his/her Phone No.________________ and the name the account is under___________________________________________

18. Have you had any other vet care for your pets?_____ With whom?_______________ When?_____________________Why?_______________________________________

19. No. of people in your household_____ No. of children_____ Ages-____thru____

20. Type of housing: house___ condo/apartment___ housing project___other________

21. Do you own or RENT?________________

22. If renting, please list the name, address and phone no. of your landlord___________ _______________________________________________________________________

23. How long have you lived at your current address?____________________________

24. If renting, and forced to move to a no-pets allowed location, what would you do?____ _______________________________________________________________________ _______________________________________________________________________

25. Have you ever surrendered a cat and WHY?_______________________________

26. Please list the names and phone numbers of three references, not related and not living with you, who have known you for at least five (5) years:

1.____________________________________________________Tel.______________

2.____________________________________________________Tel.______________

3.____________________________________________________Tel.______________

27. Are you comfortable with a SAFER representative doing a follow-up home check once your new pet has settled in? YES / NO

28. How did you hear about our group, SAFER.?______________________________ _______________________________________________________________________

29. Would you like to volunteer?____

SAFER reserves the right to refuse adoption to anyone, for any reason and at any time during the adoption process. SAFER may confiscate any cat or kitten because of falsification of this adoption application. No cat or kitten will be adopted out to anyone having any history of losing, selling or giving away their pets or to anyone who has shown negligence to the safety of their pet(s). Adoptions will not take place if information is misleading or inaccurate on this application. If for any reason you are unable to keep your cat(s)/kitten(s), you agree to release the animal(s) to SAFER., unharmed and without any financial obligation on SAFER’s part.

Signed:___________________________________________Date:________________

Reviewed by:______________________________________Date:_________________________