Hi, Have we met somewhere before...? I have already visited the shelter to meet the cat I want to adopt! * Have you come to see us yet, and spent time with the dog you would like to adopt? Yes No I met my perfect cat on: If you have already met the cat you would like to adopt, when did you visit? MM DD YYYY I dealt with: Name of the Sammy's Hope staff or volunteer who introduced you (if you remember!) Contact and Personal Information Name * Name First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Mobile Phone * Mobile Phone (###) ### #### Home Phone Home Phone if different than Mobile (###) ### #### Email * Driver's License Number Age * 18-20 21-25 26-40 41-50 51-64 65+ Occupation Employer Will this pet be co-owned by another person? * Yes No Co-owner Name If so, please provide the following: First Name Last Name Co-owner Phone (###) ### #### Co-owner Driver's License Co-owner Email Co-owner Age 18-20 21-25 26-40 41-50 51-64 65+ How did you hear about Sammy's Hope Animal Adoption & Welfare Center? Petfinder, Adopt-a-Pet, etc. Sammy's Hope Website Facebook Twitter Instagram Friend/Relative Prior Adopter Other Other: If you chose "other" please tell us where you heard about us: Do you live with: Spouse/Partner Children Parents Roommate Alone How many adults (21+) live in your household? How many people under the age of 21 live in your household? What are their ages? Have you received permission to adopt from each adult in your household? Yes No Do you live in: * House Townhouse Apartment/Condo Other Do you rent or own your home? * Rent Own Other/Live with family/friend If you rent, does your lease allow pets? Please note that you must provide a copy of your current lease prior to finalizing an adoption Yes No I don't know If renting, what are your lease restrictions regarding pet ownership (size, breed, type, number, etc) Lifestyle and Experience Please describe your household/lifestyle: Active - many visitors in and out, travel a lot, hiking, running, camping, etc Relaxed/Structured - quiet household, not many visitors, structured daily routines, etc Do you currently have any other pets living in your household? * Yes No If yes, please tell us about them! Please list your current animals, and provide the following details of other dogs in the home: sex, age, and whether they have been spayed/neutered: If you have had other cats in the past, please let us know what happened to them: Check all that apply Died of old age Died of a fatal disease Gave away to friend or relative Gave to a shelter Hit by a car Lost/Disappeared Other If "other" please explain: What arrangements would you make for the care of your pets in case of an emergency or if you become unable to care for them? Have you ever been convicted of an offense other than a traffic violation? Yes No If yes, please explain: Cat you are interested in adopting Choice #1 What did you like about this cat? Choice #2 What did you like about this cat? Cat's living situation will be: Please select all that apply House pet, living inside with a family Will live in basement of garage Will live outdoors Other If "other" please explain: When home alone, cat will be: Choose all that apply Contained/Confined Loose indoors Loose outdoors Other If "contained/confined" or "other" please specify: References If you have owned pets in the past, or see a veterinarian for your current pets, what is the name of the vet office? Name of the primary doctor seen? Name of pets in their care? Name of a non-family member personal reference: (only required if you do not have a veterinarian reference) First Name Last Name Phone of personal reference (###) ### #### Years acquainted? Do you agree to take the cat for a veterinary exam within 7 days of adoption? Yes No Do you intend to de-claw the cat? Yes No What would cause you to decide to return the cat? Is there anything else you would like us to know? Sign-off: * I certify that all information is true and complete, to the best of my knowledge. Thank you for applying to adopt from Sammy’s Hope!
