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Basic Information
All forms must be completed on laptops or desktops!
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Indicates required field
Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Phone Number
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Your Information
What pets do you currently have?
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What physical and personality traits are you looking for in a companion animal?
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Where will you keep your cat? Inside, Outside, or both?
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Inside
Outside
Inside/Outside
Will you have your cat declawed?
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Yes
No
Comments about cat declawing?
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What type of residence do you live in?
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House
Apartment
Condominium/Townhouse
Mobile home
Trailer
Other
Do you own or rent your residence?
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Own
Rent
Lease
If you rent your residence, may we contact your landlord?
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Yes
No
Landlord Name
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Landlord Phone Number
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Do any children live in the home (or visit regularly)?
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No
Yes
Ages of Children
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Will you keep the animal up-to-date on vaccinations?
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No
Yes
If you go away for a few days or on vacation, who will take care of your pets?
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Are you willing to have a representative of the Agee Memorial Wildlife Fund come to see where the pet(s) will be living?
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Are you willing to take the responsibility for this pet for the next 10 to 15 years?
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No
Yes
What type of animal are you looking to adopt (specific breed, gender, barn cat, etc)?
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Is there a particular animal that you are looking to adopt? (Please enter their name)
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References
In the spaces below please provide the names of two individuals who know you as a pet owner. No family members, please. (Example: personal contacts, neighbors, previous vets and/or pet sitters, etc.
Reference #1 Name
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First
Last
Phone Number
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Reference #2 Name
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First
Last
Phone Number
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Who is your veterinarian? (Please list name, address and phone number)
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Contract
Please indicate your acceptance of each of the statements below by placing a check mark in the appropriate box.
DECLAWING OF CATS, ABUSE AND/OR USE FOR EXPERIMENTATION:
I agree that the listed cat{s) will never be declawed, and I hereby agree that this cat will never be hit, mistreated or abused in any manner. I further assure that I will not give away or sell this cat to any animal control facility, medical laboratory, shelter, pound, or to any other person, company or organization without prior written consent from an Agee Memorial representative.
For the "DECLAWING OF CATS, ABUSE AND/OR USE FOR EXPERIMENTATION" statement above my response is:
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I agree.
I disagree.
MINIMUM LEVEL OF CARE AND HANDLING:
I hereby agree to treat this cat with love and kindness and to provide this cat with proper food, clean water, adequate shelter, and prompt veterinary treatment should it become ill or injured. I will continue to vaccinate this cat as recommended by a licensed Veterinarian. I understand that my cat might be spooked at loud noises, or hides under the bed, as these may reflect an adjustment to unfamiliar sights, sounds and smells which may take a few weeks of love and patience to overcome. If at any time my cat wears a collar it will be a "cat-safe" collar. I agree to provide a proper animal carrier for my cat anytime we are traveling. If my cat becomes lost, I will contact an Agee Memorial representative IMMEDIATELY, regarding procedures and/or assistance in finding it. I understand that this cat is currently microchipped and the microchip information shall remain in the name of Agee Memorial Wildlife Fund, Inc.
For the "MINIMUM LEVEL OF CARE AND HANDLING" statement above my response is
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I agree.
I disagree.
UNDERSTANDING OF COMMITMENT:
I fully understand that I am making a very serious commitment to keep this cat for the rest of its natural life, which may be as long as 20 years or more. In the event that my cat becomes incurably ill and is suffering as a result, I hereby agree to show compassion and have my own veterinarian humanely euthanize the cat by painless injection. I understand that the cat I am adopting is a rescued animal; its age, breed, temperament and/or health cannot be, and are not, guaranteed by Agee Memorial. If this cat becomes ill or unsuitable for my home within thirty (30) days of the adoption I may exchange it for another cat. I understand and hereby agree that my donation is non-refundable and will help Agee Memorial continue its rescue work, even if the cat is reclaimed by Agee Memorial Wildlife Fund Inc.
If for ANY reason I am unable to keep this cat and/or provide a proper home, I will return the cat to Agee Memorial, regardless of the time that has elapsed since the adoption. If I move, I will make sure that my pets are allowed in my new home and I agree to provide Agee Memorial Wildlife Fund, Inc. with my new address and telephone number. This is a co-ownership contract. Agee Memorial has rescued this cat for its lifetime and reserves the right to follow-up this adoption with telephone calls and/or home visits concerning its welfare.
For the "UNDERSTANDING OF COMMITMENT" statement above my response is:
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I agree.
I disagree.
RELEASE OF LIABILITY, INDEMNIFICATION AND HOLD HARMLESS PROVISION:
I agree to release, indemnify and hold harmless Agee Memorial Wildlife Fund, Inc., its Board of Directors, agents, members and volunteers from any and all known, unknown, or unanticipated claims or damages which may arise out of or in connection with my adoption, ownership or control of such cat.
For the "RELEASE OF LIABILITY, INDEMNIFICATION AND HOLD HARMLESS PROVISION" statement above my response is:
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I agree.
I disagree.
RECLAIMING THIS CAT:
Agee Memorial reserves the right to reclaim this cat should any of its agents or volunteers discover that any information submitted on the Adoption Application is false or inaccurate. We further reserve the right to reclaim this cat due to breach of this contract including, but not limited to, should it EVER be DECLAWED.
For the "RECLAIMING THIS CAT" statement above my response is:
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I agree.
I disagree.
MICROCHIP
:
I understand that this cat has been microchipped, and I hereby agree that said cat's microchip records will be in my name as the primary contact, and that Agee Memorial Wildlife Fund shall be named as the secondary contact. Under no condition or circumstances I will change or alter said records to anyone else's personal or group name without prior written consent of an Agee Memorial representative. If any representative of Agee Memorial Wildlife Fund, Inc. learns that the microchip records have been altered or changed in any way without said prior written consent, upon request, I will surrender the cat immediately to a representative of Agee Memorial Wildlife Fund Inc.
For the "MICROCHIP" statement above my response is:
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I agree.
I disagree.
The Agee Memorial Wildlife Fund, Inc., will offer medical care up to 30 days from the date of adoption only through cooperative veterinarian's we have an account set up with. Please contact a representative from AMWFI in order to allow us to make the appointment(s). Since we are a non-profit organization, we can only guarantee medical costs in this manner. If you choose to treat the animal through your own veterinarian during the 30-day period, you are fully responsible for all costs incurred.
The adoption is being arranged under the premise that all the answers filled out on the application are true and factual. Agee retains the right to void the adoption, refund the adoption fee, and take immediate possession of the animal(s) should any material fact on the application be untrue.
By typing my Electronic Signature in the name/date section below I acknowledge that I have read, completely understand, and agree to the terms in this ADOPTION CONTRACT before signing and I will RETURN the adopted animal(s) back to the AGEE MEMORIAL WILDLIFE FUND, INC., if for any reason the animal(s) should not be suitable.
Electronic Signature
Please type your full name and today's date.
Name
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First
Last
Today's Date
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Submit
Get in contact with us.
Our organization is ran on volunteers like you. To get in contact with us for any reason, use the methods below.
Fat Kitty City
2222 Francisco Dr.
Suite 220
El Dorado Hills, CA 95762
MAIN: (
916)-939-3418
[email protected]
Home
About
About Us
Special Thanks
Blog
Adopt
How to Adopt
Apply to Adopt Link
Cats for Adoption
Kittens for Adoption
Ways to Help
Volunteer
Wish List
Planned Giving Programs
Sponsor a Kitty
Found an Abandoned Cat?
Foster
Contact
Donate
Cat Care Tips