Adoption Application

Potential Adoptee

Loki photo
Loki
Name: Loki Description: Male, 4 years old (DOB 7/1/2020), Poodle, White (Remove)

Adopter Information

First name:
  Last name: 
Age:
Address: 
City:
State:
ZIP:
Country:
Home phone:
Cell phone:
Work phone:
Email:
Verify email:
Employer's Name?  Position?
Time on the job?
How long at this address?
Is it a: House Apartment Condo Mobile Home Other
Do you Rent Own Live with someone who owns your home?
Are you allowed animals? Yes No
  Pet deposit amount $
Landlord's name: Landlord's phone:
Homeowner: First name: Last name: Phone:
Does your home have a fenced yard? Yes No
Number of adults in the home?
Number of children in the home? Ages of Boys? Ages of Girls:
Does anyone in the home have allergies? Yes No
Do you currently have pets? Yes No
 
  Other Species Age Fixed Breed (Dogs) Temperament
1.
Cat Dog Other
Yes No
2.
Cat Dog Other
Yes No
3.
Cat Dog Other
Yes No
4.
Cat Dog Other
Yes No
5.
Cat Dog Other
Yes No
6.
Cat Dog Other
Yes No
7.
Cat Dog Other
Yes No
8.
Cat Dog Other
Yes No
 
Where are your pets now?
What pets have you had previously as an adult? Please include their ages and how long you had them.
What happened to them? If they died, what was their cause of death?
If no pet experience as an adult, can you tell us about any pet experience that you have had?
Does your home have a doggy door to the outside installed (used or not)? Yes No
Is the doggy door open for pet use at any time during the day? Yes No
Have you or anyone living with you adopted a pet from The Cat House on the Kings before? Yes No
Veterinary Clinic you (will) go to: Clinic Phone:
Will this pet be living in your home with you? Yes No
Describe the personality/temperament of the ideal dog:
As a puppy where will Loki be? Indoor only Outdoor only Indoor/Outdoor
As an adult where will Loki be? Indoor only Outdoor only Indoor/Outdoor
How many hours will Loki be left alone during the day?
Have you ever surrendered an animal? Yes No
Please explain:
Have you ever had a pet hit by a car? Yes No
Have you ever lost a pet or had one die of accident or injury other than being hit by a car? Yes No
Do you know how to treat the following?
 
Fleas: Yes No
Ear Mites: Yes No
 
Tape Worms: Yes No
Round Worms: Yes No
How much do you think it will cost per month on average to care for Loki? $
Who will be primary caretaker for Loki?
Who will take care of Loki if you go away for a few days?
Non-household FAMILY reference name. (We only accept FAMILY as as reference. Do not list a friend):
First name:
Last name:
Phone:
Please note: We require an actual reference. If you have no family, please use a professional person who knows you.
Reference's address: City:
State:
ZIP:
Would you consent to a home visit? Yes No
Why?
How did you hear about us?
If you move, what will you do with Loki?
Full name of person who will care for Loki if you are unable to?
Are you financially able and willing to give Loki the medical care he may need? Yes No
Are you prepared to care for Loki for his natural life (which may be over 15 years)? Yes No
May we call you at work if unable to reach you at home for our follow-up calls? Yes No
Is there anything else you'd like to tell us?

Signature

I certify that I am at least 18 years old.
I certify that the above information is true and understand that misrepresentations may result in the cancellation of the adoption.

Please note: We do not share your information with any other organization or company for any purpose whatsoever.

  • The adopter must pick up the dog in person from The Cat House on the Kings sanctuary or off-site Adoption Center. If you live outside Central California, you will have to travel to our adoption center in Central California where the dog is being cared for. To ensure the safety of the dogs in our care, we will neither transport or ship them nor will we allow a third party to pick up the dog on the adopter's behalf. We may make an exception on a case-by-case basis for an immediate member of the adopter's family. If this requirement is not acceptable to you, please do not submit an application!
  • If you choose to travel from out of the area to The Cat House on the Kings and adopt from us, you must agree to accept 100% of the financial responsibility for the care of the dog(s) and that if something does not work out with the dog(s), you will be responsible for returning the dog(s) to us safely at your expense. (We do not have the ability or financial resources to travel out of the area to retrieve our cats.) If this requirement is not acceptable to you, please do not submit an application!