Barn Cat Adoption Application This application is for anyone intending to adopt a barn cat from our organization. Please fill out each section completely and truthfully. * indicates required field "*" indicates required fields Step 1 of 5 20% Application Date* MM slash DD slash YYYY # of Cats looking to adopt* 1 2 3 more than 3 Enter number of cats looking to adopt*Have you ever adopted from other rescues* Yes No Please list the rescuesDo you currently reside outside of Texas or plan to move outside of Texas in the next 3 months?* Yes No Other Please explainNHAR does not currently adopt our animals to residents outside of Texas. If you feel this message is being displayed in error, please do not hesitate to Contact UsGeneral InformationName* First Last Email* Enter Email Confirm Email Cell Phone*Work PhoneHome PhoneAge Group*--please select--Under 2121-2526-3435-4445-5455-6465 or AboveWe cannot proceed with the application due to age restriction. Thank you for your understanding and cooperation. If you feel this message is being displayed in error, please do not hesitate to Contact UsAddress*Where you currently reside. Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the above address also a business address? Yes No Will the cats live at the same address?* Yes No Name of the Business*Second AddressProvide the address where the cats will reside Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Type of facility for the cats:* Farm/ranch with barn or outbuilding Stable Residential home with garage or shed Warehouse Other Please explain*Does the facility currently house barn cats?* Yes No How many?*Are the current barn cats spayed and neutered?* Yes No Explain*What will you feed the cats?*Mark any that apply Dry Cat food only Wet Cat food only A mix of dry and wet cat food Leftover scraps No food provided What feeding schedule do you use for the cats?* Once in AM and once in PM Once daily (AM or PM only) Other No food provided Please provide more info*Are you able to provide access to fresh water at all times?* Yes No Please explain*Have you lost cats to coyotes or predators recently?* Yes, several, it's inevitable Yes, but only few Yes, it was an unfortunate accident No Cats' Medical CareHow long are you planning on keeping your new cat(s) confined indoors or in a large crate to acclimate to their new environment?* Release immediately 1 week 2 weeks 3 weeks 4 weeks as long as it takes Will this enclosure during acclimation be temperature controlled?* Yes No Will you be able to provide Basic Veterinary Care for your Barn Cat(s)*For example: vaccinations, parasite treatments, and flea preventatives—as well as emergency vet care for illness or injury? Yes No Please explain*Do you currently have a veterinarian?* Yes No Please explain*You've identified that you live with or own pets, please explain why you do not currently have a veterinarian. Have you had a Vet in the past?* Yes No Please explain*You've identified that you have had pets in the past, please explain why you did not have a veterinarian. Vet's Name*Dr's Name or Medical GroupVet's Phone number*Vet's Email Do you have other ideas on how to keep your outdoor barn cats safe and well cared for?Is there anything else you would like us to know? References*** Please provide a name of someone who does not live with you. ***1st Reference* First Last Phone*Relationship*2nd Reference* First Last Phone*Relationship*Adoption Agreement, Consent and SignaturesHousehold Adoption Consent and Declarations* I declare that all adults living at the provided address are aware and are in agreement to adopt this(these) pet(s)* I authorize New Hope Animal rescue to contact my references, including my veterinarian to verify the information I have provided on this application * I understand that if New Hope uncovers any information on this application to be false, that the pet will be reclaimed by New Hope Animal Rescue. * I permit New Hope Animal Rescue to conduct a home visit, which will be scheduled in advance. * I agree that this pet shall not be sold, given, or adopted to anyone else, nor shall it be given to a shelter or other rescue organization. This pet adopted from New Hope Animal Rescue must be returned to New Hope Animal Rescue for any reason if I can no longer keep this pet. * I understand that cats can live up to 20 years and can cost up to $500-$1,500 each year for basic nutrition and vet care. I am willing to accept financial responsibility for this animal. Declarations* I understand that all animals adopted out from New Hope Animal Rescue will be spayed/neutered as New Hope does not adopt out cats for breeding. If a kitten is not spayed/neutered at time of adoption, New Hope Animal Rescue requires this be done at 4 months of age. Refusal to alter an animal will result in immediate removal from the home. Signature PageApplicant Signature*Type your full nameToday's Date*Enter today's date MM slash DD slash YYYY Co-applicant SignatureType your full nameToday's DateEnter today's date MM slash DD slash YYYY Co-applicant's PhoneCo-applicant's Email Authorization Signature* By checking here you to agree to the terms and conditions of this application.*Terms & Conditions: By submitting this application, You are not obligated to adopt. Adoption fees are due at the time of pickup. You attest that the person signing is your true self and all statement are true to the best of your knowledge.CAPTCHA NameThis field is for validation purposes and should be left unchanged. Δ
