Tracies Loving Care

39 Womma Road Elizabeth North SA 5113

Phone: 0412963498
Page: https://www.facebook.com/PageTraciesPlace
Web: http://traciesplace.weebly.com
Email: consumesyou@hotmail.com

Page 1 of 4

Feline Adoption Application

Animals Name:

Todays Date:

We are committed to finding the best home for every animal in our care. We also want to ensure that the cat
you adopt is the best suited for your family and lifestyle. Please answer the following questions in order to
help us make the best adoption. We review each application carefully. Please understand that there may be
times where it is necessary to deny an application. We reserve the right to deny any application at any
time.

Your name (first, middle, last):
Your permanent street address, where the cat will live:
City State Zip:
Home Phone #: Work Phone #: Cell Phone #:
Email Address:
Second point of contact: Name (first, middle, last):
Permanent street address: (or as above)
City State Zip:
Home Phone #: Cell Phone #:
Email Address:
Please complete the following information regarding the household in which your pet will reside:
How many adults live in this house?
How many children live in this house?
What are the ages of the children?
What type of dwelling do you live in? (Circle one)
House: Condo: Apartment: Mobile Home: Farm: Dorm: Other:
I live with (Circle one): Parents: I rent: I own: Other:
Tracies Loving Care
39 Womma Road Elizabeth North SA 5113
Phone: 0412963498
Page: https://www.facebook.com/PageTraciesPlace
Web: http://traciesplace.weebly.com
Email: consumesyou@hotmail.com

Page 2 of 4

If you rent, does your landlord allow pets?
Landlord name and phone #:
Are you over 21 years of age and have identification saying so? (a photocopy is required)
What type(s) of pets have you owned in the past 5 years?
Name of Pet Breed/Type Age Sex Kept in, out, or both? Altered (fixed) Still have?
___________ ___________ ____ M F ____________________ Yes No Yes No
___________ ___________ ____ M F ____________________ Yes No Yes No
___________ ___________ ____ M F ____________________ Yes No Yes No
__________ ___________ ____ M F ____________________ Yes No Yes No
___________ ___________ ____ M F ____________________ Yes No Yes No
If you no longer have the pet(s) listed above, please explain what happened to him/her:


How much do you think the cost of spaying and neutering is?
It may take your new cat a month or more to adjust to a new home. Are you prepared to allow this much
time? (Circle one) Yes No
Concerns:
Where will you keep the cat during the day and night?

Do you plan to let the cat outside? (Circle one) Yes No
If yes, how often?
Do you plan on restraining the cat or restricting its movement outside? (Circle one) Yes No
If yes, how will you do so? (Circle one) Leash: Fenced yard: Cat enclosure: Under my supervision:
Other:
When youre not home, the pet will be: (circle one) Confined to a room: Have run of the house: Kept
outside: Other:
Tracies Loving Care
39 Womma Road Elizabeth North SA 5113
Phone: 0412963498
Page: https://www.facebook.com/PageTraciesPlace
Web: http://traciesplace.weebly.com
Email: consumesyou@hotmail.com

Page 3 of 4

Is the cat being adopted as a (circle all that apply): Companion Gift: Mouser: Companion for other pet:
Other:
Do all members in the home know you plan to adopt?
Does anyone in your home have allergies?
Who will be the cats primary caretaker (feeding, grooming, vet trips, etc.)?
Have you been convicted of, or received citations for, the violation of Federal, State, or Municipal animal
codes? (Circle one) Yes No
If yes, please explain:

Please provide a brief description of how you would correct your new kitten/cat if it showed destructive
behaviour? (I.e. clawing, biting, scratching)


Change is inevitable in ones lifetime. What will you do if you move/can no longer care for your animal?


If you have had pets in the past, which veterinarian did you use? (Make sure to write in all information,
application may be denied if it is missing) By providing this information you are giving us permission to
contact your vet should the need arise.
Vet Clinic & Vets Name:
Address, City, State, Zip:
Phone Number:
Name your records will be under:
Name of pets seen by vet:

Do you have any Questions, Requests or Comments





Tracies Loving Care
39 Womma Road Elizabeth North SA 5113
Phone: 0412963498
Page: https://www.facebook.com/PageTraciesPlace
Web: http://traciesplace.weebly.com
Email: consumesyou@hotmail.com

Page 4 of 4

ADOPTION CONTRACT
I hereby adopt the animal described above from Tracies Loving Care Cat Rescue (further known as TLC)
with the knowledge that although it has been examined and evaluated. TLC can make no warranty as to the
health, condition, temperament, or otherwise and can only give such information to me as they have
received with regard to the animal. I am fully aware that I am adopting a living creature and, as such, TLC is
unable to guarantee the health of any animal. If this animal becomes ill, I certify that I am financially and/or
emotionally prepared to treat this animal at my own expense but am able to return the pet to TLC without
penalty or fee with in 7days for examination by our vet.
I shall be responsible for the humane care and control of the animal by providing the animal with proper
food, water, shelter, exercise, attention, and veterinary care. The TLC Agent shall be allowed to see the
animal or its living conditions at any time. I further understand that any adoption fees I have paid is
considered a donation toward caring for this and other animals and will not be refunded should I choose to
surrender this animal back to the care of TLC. I also understand that if I need to return the animal to TLC,
that I may need to set an appointment. If the animal is in need of vet work upon return, I understand that I
may be responsible for this cost. I hereby understand that I must maintain the F3 or greater vaccinations and
licensing of this animal as applicable to my council. If I fail to comply with any term of this agreement or
find myself unable or unwilling to keep the animal, I must surrender the animals described to TLC. I
further agree to pay any legal fees from the enforcement of this agreement. By signing below, I certify that
the information I have given is true and that I recognize that any misrepresentation of facts may result in
losing the privilege of adopting a pet. I understand that TLC has the right to deny my request to adopt an
animal, and I authorize investigation of all statements in this application. Local veterinarians may offer a
free health exam with proof of adoption; I must contact my vet to see if this is possible.
Signature: Date:
Name (Please Print):
TLC Agents Signature and name:
OFFICE USE ONLY
Staff: Initial and date each itemed as completed:
Veterinarian Reference:
Landlord Permission Form: OR Proof of Homeowners:
Property Inspection:
Application Approval:
Photocopy of Photo ID:
Staff Comments: