First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
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Cell Phone*

Alt Email

Which animal are you interested in?*
Choose an animal: Cat not on Website Placeholder Nova Walker

Are you over 18?*
Choose one: Yes No

Is this cat for yourself or a gift for someone?*
Choose one: Self Gift

If this cat is a gift for another adult, the adult who will have ownership of the cat must fill out this application. 

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

If you rent, please enter your landlord’s name and phone number to verify you are allowed to have a cat in the home. If you own, enter "N/A".*

How many hours per day will the cat be left alone?*

Will the animal be kept inside or outside?*
Choose one: Inside Only Outside Only Inside and Outside

If Outside, please explain. If inside, say "Inside Only". *

Are there children in your home or that visit on a regular basis? *
Choose one: Yes No

If yes, list ages:

If yes, have these children been exposed to a cat for a prolonged period of time?
Choose one: Yes No

Are there persons with allergies to cats or other persons such as an older diabetic whose health might be affected by the presence of a cat in your home?*
Choose one: Yes No Maybe Unknown

Are there other pets in your home? *
Choose one: Yes No

If there are other pets, please describe:

Veterinarian’s name and phone number:

Your cat may live up to 20 years or more.  Do you have the time and financial means to care for a cat for its entire lifetime, including medical expenses?*
Choose one: Yes No

What is the plan for taking care of your cat if you are out of town? *

If you had to give up your cat due to an unplanned life event, who can you trust to take responsibility for the care of your cat long term? *

Why are you interested in adopting a pet at this time?*

How did you hear about us?

I understand that an approved application does not guarantee that the kitten/cat will be placed with me. The final decision rests with our foster families, as they know their cats best. Cats are not placed on a first come, first serve basis; they are placed based on which home is the most appropriate and best fit. If you are not selected for your first choice cat, please give us an opportunity to match you with another cat that is likely equally wonderful. *
Choose one: I Agree

This cat is being adopted as a family pet. The cat will have extensive housing privileges and remain safely inside the home unless arrangements are made in writing prior to adoption. I agree to provide this cat with proper food, water, shelter, love and necessary veterinary treatment.  I agree to give DK visitation rights to ensure that the terms of this adoption agreement are being observed.  *
Choose one: I Agree

I WILL ASSUME ALL RISKS AND RESPONSIBILITIES REGARDING THIS CAT’S MAINTENANCE, WELFARE AND HEALTH CONCERNS.  I agree that the cat being adopted under the terms of this contract appears to be in good health; however, I understand that DK obtains cats that are strays or from a third party. Therefore, all information regarding its age, health status, or other issues is estimated and IS NOT WARRANTED by DK. Dexter’s Kitties is not responsible for any medical expenses incurred after the adoption process. We suggest a “wellness” exam at your personal veterinarian’s office as soon as possible after adoption. *
Choose one: I Agree

If the cat has medical complications within three days of adoption, I may contact DK for assistance. Please contact us FIRST unless it is a medical emergency.  Often we can provide simple guidance that will save you time and money to address the situation.  If you cannot reach us or it is a medical emergency, do not delay, see your veterinarian ASAP. *
Choose one: I Agree

Dexter’s Kitties will refund the adoption fee if the cat is returned within the first 3 days following the adoption.  All medications, toys, blankets, or other such items provided by DK must be returned in order to receive the refund. After 3 days, the adoption fee will not be refunded. *
Choose one: I Agree

DK is not held responsible for any problems, accidents, or financial expenses after I take ownership of the cat. I release DK from any liability associated with any damage, accident or injury here after caused by the cat.*
Choose one: I Agree

I will register my name and phone number with the chip registration company and keep my number updated in the system. www.FoundAnimals.org is a free service.*
Choose one: I Agree

Photos of me and the cat taken by or sent to DK can be posted on social media, unless I say otherwise. *
Choose one: I Agree

DK may register my name and contact information with PetSmart and its marketing programs.*
Choose one: I Agree

By submitting this form, I certify all the above information is true. Any false information or failure to comply as agreed may result in Dexter’s Kitties reclaiming the cat without reimbursement and or placing your name on a national Do Not Adopt list. *
Choose one: I Agree