Cat Adoption Application

Your Name*

Address*

Town*

Postal Code*

Phone Number*

Alternate Phone Number

Email

Do you have a specific ICAN animal in mind? Tell us its name

Who are you adopting this animal for?*

Have all members of your household been introduced to the animal?

Yes
No

Number of Adults at home? (18+ yrs)*

Please enter a number from 1 to 10.

Number of Young Children at home? (0-7 yrs)*

Please enter a number from 0 to 20.

Number of Children at home? (8-17 yrs)*

Please enter a number from 0 to 20.

Any severe allergies in your family?*

Yes
No

How busy is your family?*

Very
A little
Sometimes
Not at all

How would you describe yourself?*

Loud
Calm
Quiet

How would you describe the others in your house?*

Loud
Calm
Quiet

Are you planning on the following in the next month? Moving, Holiday, Major Change in Schedule

Do you have a family vet?

Yes
No
Not yet

Veterinarian Contact Information:

Type of home?*

House
Apartment
Acreage

Rent or own?

Rent
Rent Share
Own
Own Share

Outside areas?

Who will be the cat’s primary caretaker?

Where will your cat stay during the day?

Outside
Inside
Both
Other

Where will your cat stay during the night?

Outside
Inside
Both
Other

Where will your cat stay during vacations?

At home with no care
At home with care
Boarded
With a friend

Have you had cats before?

Yes
No

What happened to them?

Have you ever surrendered an animal to a shelter?

Yes
No

Why?

Do you have the landlord’s permission to have pets?

Yes
No

Please give landlord’s name & phone number

Do you have other cats?

Yes
No
Third Choice

Please Specify for Cat #1

Spayed Female
Intact Female
Neutered Male
Intact Male

Temperament with other cats

Friendly
Disinterested
Afraid
Not Sure

Please Specify for Cat #2

Spayed Female
Intact Female
Neutered Male
Intact Male

Temperament with other cats

Friendly
Disinterested
Afraid
Not Sure

Please Specify for Cat #3

Spayed Female
Intact Female
Neutered Male
Intact Male

Temperament with other cats

Friendly
Disinterested
Afraid
Not Sure

Do you have other animals?

Yes
No

Please specify type and breed for #1

Temperament with other cats

Friendly
Disinterested
Afraid
Not Sure

Please specify type and breed for #2

Temperament with other cats

Friendly
Disinterested
Afraid
Not Sure

References are required - Please list two references who can comment on your character and experience with animals. REFERENCES MUST NOT BE FAMILY MEMBERS

Reference 1*

Please include Name, Phone number and Relationship to this person

Reference 2

Please include Name, Phone number and Relationship to this person

Desired Animal

Desired Sex

Male
Female
Either

Coat

Short
Medium
Long
Either

Age

Kitten
Adult
Senior
Any

Breed, Type, or Color

Be Friendly with people/pets

Very Important
Important
Not Important

Be interactive with you

Very Important
Important
Not Important

Activity Level

Never scratch the furniture

Very Important
Important
Not Important

Always use the litterbox

Very Important
Important
Not Important

Never show aggressive behaviour

Very Important
Important
Not Important

Problems you are willing to work on

I'm interested in working on problems

Yes
No
Depends

Behavioural Problems

Litterbox
Scratching Furniture
Both

Will you have this cat de-clawed

Yes
No

Socialization Problems

Fearful
Shyness
Nervousness
All of the above

Under what conditions would you return your cat to ICAN?

Aggressive, Too timid, Wrong decision, Scratching furniture, Litter box problem, Does not get along with other pets, Too costly, Not enough time, Cat's health problems, New baby

How long will you give your new cat to adapt to his/her new surroundings?

Less than a week
One to two weeks
One Month
As long as it takes

Agreements

Have you ever been convicted of neglect or cruelty to animals?

Yes
No

Are you willing to have an ICAN representative do a home visit by appointment?

Yes
No

If no, why?

Tick the checkboxes below to indicate to us you completely understand and agree to the following statements.

It is my responsibility to see and evaluate this kitten/cat for myself before agreeing to adoption
This kitten/cat will reside in my home as a companion. I will provide him/her with adequate food, water, shelter, affection, socialization and medical care
I will not sell, trade, give away or otherwise dispose of this kitten/cat. If at any time I am unable OR unwilling to care for this kitten/cat, I agree to contact ICAN to return him/her to ICAN or to discuss finding him/her a new home
ICAN is in no way liable or responsible for any damage, accident or injury resulting from the placement of a kitten/cat into my household
ICAN cannot be held responsible for any health or temperament problems of this kitten/cat
I will inform ICAN of any changes to my contact information

Your comments:

ICAN DISCLAIMER
Falsified information will lead to automatic rejection of the application. ICAN reserves the right to refuse any applicant. I declare that all information provided in this application is true and complete. ICAN exercises due diligence and will disclose all known previous history for each rescue animal we place. ICAN is not liable for any unforeseen behaviors that might arise after adoption. ICAN does our best to access and provide as much information as possible on each animal that comes into our care and expects that all Adopters are aware that new situations may have the potential to bring out unknown issues. We also ask that all Adopters agree to not surrender any animal we place for euthanasia unless that is the only option or course of treatment recommended by a licensed Veterinarian. All Adopters must agree to not declaw any animal adopted through ICAN. Declawing is illegal in British Columbia and Nova Scotia and ICAN adopters hereby agree not to declaw in any other province in Canada. THANK YOU FOR COMPLETING THIS APPLICATION FORM. THIS INFORMATION WILL HELP US MATCH YOU WITH THE RIGHT CAT FOR YOUR FAMILY.

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