Caly's Cats Adoption Application

Dog Adoption Application

Have you read about how to adopt a dog or puppy from Caly's Cats?
(Required form fields are in bold.)
Our form may seem a little long, but we see ourselves as match-makers. Our goal is to match the right cat(s) and the right person. We know our cats. Now we'd like the chance to get to know you! You may have fallen in love with a particular one of our cats; help us to help you make sure the love will last! Thank you for thoughtfully filling this out completely!

Contact

Name:
First: Last:
Address: 
 
City:
State:
Zip:
Home phone:
Work phone:
Cell phone:
Email:
Employer? Occupation? How much travel?
Please provide two personal references:
1. Name: Phone:
2. Name: Phone:

Dog

Chimuelo photo
Chimuelo
Name: Chimuelo Description: Male, 4 years old (DOB 7/1/2020), Siberian Husky / German Shepherd Dog, Brown/White (Remove)
1. What type of dog are you interested in?
Male Female
Adult Puppy (under 5 months) Senior (9+ years)
Long Hair Medium Hair Short Hair
Color:
Personality characteristics you would like (check all that apply):
Shy Talkative Quiet Affectionate
Friendly to people Friendly to cats Aloof Independent
Likes to sit on laps Likes being held Wants to be left alone
Wants to be in charge Mischievous Relaxed Very active
Playful Easy going Nervous Sleeps a lot Plays rough
Any characteristics you'd prefer not to have?

New Home

2.Do you own or rent your residence? Own Rent
Landlord's name: Landlord's phone:
Are companion animals allowed? Yes No Don't Know
3.Where do you live? House Townhouse Condominium Apartment Moblie home Farm
4. How far from the road/traffic is your home located?
5.How heavy is the traffic on this street? Light Medium Heavy
6. How many adults in your household?
7. How many children in your household?
List ages:
8.Does anyone in your household have any allergies to animals? Yes No
Please explain:
9.How active is your household? Very active Somewhat active Somewhat quiet Very quiet
10.If you have a dog, where does he/she spend his/her time? Mostly inside Mostly outside
When outside, how is he/she confined? 

Dog Care

11.For whom are you adopting Chimuelo? Self Gift
12. Who will be be responsible for Chimuelo's care?
13.Where will Chimuelo be kept? Indoors only Outdoors only Both in & out
When outdoors will Chimuelo be attended unattended
and have collar & tags Yes No
14.Will anyone be home during the day? Yes No
15. How many hours will Chimuelo be left unattended (in or out)?
16. When no one is home, where will Chimuelo be kept?
17.Are your companion animals current on their vaccinations? Yes No
18. Please provide the name of your veterinarian:
Phone:
Please contact your veterinarian to allow release of your records to Caly's Cats.
19. How do you plan to introduce Chimuelo into your home if you have other animals?
 
20. What will you do if Chimuelo does not get along with your present companion animals?
 
21. If a disciplinary or behavior problem arises, how will you respond to it?,
 
22. What will you do if Chimuelo starts chewing household things or digging in the yard?
 
23. What will you do with Chimuelo if you have to move?

Experience

24.Have you ever had a companion animal before? Yes No
25.Have you ever adopted an animal from a rescue/animal control agency? Yes No
26.Have you ever had an adoption application rejected by a rescue/animal control agency? Yes No
What were the circumstances?
27. Describe those companion animals you still care for or that are living in your household:
Name Type Breed Age Sex Spayed/
Neutered		 Where kept during the day Where does he/she sleep How long owned
M
F
Spayed
Neutered
Unaltered
M
F
Spayed
Neutered
Unaltered
M
F
Spayed
Neutered
Unaltered
M
F
Spayed
Neutered
Unaltered
28. Describe those companion animals you no longer care for:
Name Type Breed Age Sex Spayed/
Neutered		 Where kept during the day Where did he/she sleep How long owned
M
F
Spayed
Neutered
Unaltered
M
F
Spayed
Neutered
Unaltered
M
F
Spayed
Neutered
Unaltered
M
F
Spayed
Neutered
Unaltered
29.Have you ever had to relinquish an animal you had? Yes No
What were the circumstances?

Responsibilities

30. Why do you want to adopt Chimuelo?
31. What do you think the annual cost of care for a dog is? $
32. How much do you think a large vet bill is? $
33. Are you financially able and willing to provide annual checkups, vaccinations,
and any medical care necessary? Yes No
34.Are you familiar with your local animal control laws? Yes No
35.Will you permit a dog-safety inspection of your home by appointment? Yes No
36.Are you willing to sign legal adoption papers? Yes No

Signature

By checking this box I/we certify that all information on this form is true and correct. I/we understand
that any misrepresentation of fact may result in Caly's Cats refusing adoption privileges
on me/us. If my/our request for adoption is approved and later Caly's Cats discovers the
above information is not true or correct, Caly's Cats reserves the right to remove the
adopted dog from my home.