Cat Adoption Application

Cat you're applying to adopt*
Section 1: Owner Information
Name(s)*
First Last
Address*
Street Address City State Zip/ Postal Code
Email*
Telephone (primary)*
Telephone (alternate)
Employer
Occupation
How many children are living in the household, and ages:

Section 3: Veterinary Information
Veterinary Office:*
Doctor(s):
Telephone:*
How long have you been with this vet*?*
May we contact your vet and inquire about your previous or current pet healthcare?*
(Please call your vet and give them permission to talk with us as well)
- Yes
- No
Are you willing to allow a representative from GDU to periodically visit your home?*
- Yes
- No
Do you agree to provide regular health care to your new kitten/cat?*
- Yes
- No
Do you agree that your new kitten/cat will not be de-clawed?*
- Yes
- No
How many and what types of other animals reside in the home?*
Please list names, ages, breed, male/female, and whether or not they are spayed/neutered.
If any of the animals listed above are not spayed/neutered, please state why not.

Section 4: References
Please provide contact information for two people that we can contact for a personal reference. They should be people who have known you for at least one year and not related to you. They will be asked to answer a few questions (via email) regarding pet ownership and how they feel the pet you are adopting will fit into your life.
Name (Reference 1)*
First Last
Phone (Reference 1)*
Email (Reference 1)*
Name (Reference 2)*
First Last
Phone (Reference 2)*
Email (Reference 2)*

Section 5: Agreement
Green Dogs Unleashed does ask an adoption fee of $120 per cat/kitten to help us cover expenses incurred. I certify that all of the above information is correct. Should an un-neutered or un-spayed animal be placed with me, I agree to have it neutered or spayed by such date agreed upon by me and Green Dogs Unleashed. At that time, I will forward evidence to Green Dogs Unleashed that such procedure has been completed. The animal will reside in my home as a pet and will not be allowed to live outdoors. I will provide it with adequate food, water, shelter, training, affection, and medical care. I understand that Green Dogs Unleashed is a referral service and is not responsible for the accuracy of information received about the habits, temperaments, or physical condition of animals available for adoption. I understand it is my responsibility to evaluate the animal for myself before agreeing to adopt it. I am in full agreement with these terms of adoption. Green Dogs Unleashed shall not be liable for, and is hereby relieved from all liability for any damage, expenses, causes of action, fines, suits, demands, judgements, or claims of any nature whatsoever arising from or by reason of any damage to property or injury to any persons caused in part or in whole by the cat placed in your home. I hereby accept and assume such liability and agree to protect, indemnify, and hold Green Dogs Unleashed harmless from and against all the aforesaid. GREEN DOGS UNLEASHED AND THE ADOPTER(S) AGREE THAT IN THE CASE THAT THIS DOCUMENT IS EXECUTED VIA EMAIL THAT THE ADOPTERS TYPED SIGNATURE IS VALID AND BINDING UPON THE PARTIES. I agree to mail the original application to Green Dogs Unleashed, 1171 N Boston Rd, Troy, VA, 22974.
Signature of Applicant (enter your full name):*
Date*
Date Format: MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Step 1 of 5

Section 1: Owner Information

Section 2: Housing Information

Section 3: Veterinary Information

Section 4: References

Section 5: Agreement