Application Form - Animal Allies

Animal Allies Application

Please answer the following questions. We want to help ensure the best possible match between adopter and pet. Remember, this is a lifetime commitment. You will be asked to sign a legal contract and, if applicable, a spay/neuter agreement, when adopting your pet. You will also be asked to pay a donation fee that covers the spaying/neutering, leukemia/FIV testing, distemper and rabies shots, provided the cat is of appropriate age. There will be an adoption fee.

Primary Adoption Choice*
Secondary Adoption Choice
Applicant Name*
First Last
Co-Applicant Name
First Last
Address*
Street Address City State ZIP Code
Preferred Phone*
Work Phone
Email*
Number of Persons in Household*
Adults Children/Teens Toddlers/Infants Ages of Toddlers/Infants
Have you ever adopted a cat from Animal Allies?*
- Yes
- No
When did you adopt the cat?*
Do you still have the pet?*
- Yes
- No
Have you had any other animals in the past five (5) years?*
- Yes
- No
Please list all companion animals you have been guardian to in the last five (5) years:*
Type of animal (dog, cat, other) Name of pet Sex Age Spayed/Neutered (Yes/No) How long in your care Indoor/Outdoor pet Where is the pet now?
If you have a dog, have they been exposed to cats?*
- Yes
- No
- I don't have a dog
Are your pets current on vaccinations?*
- Yes
- No
What veterinarian sees and vaccinates your pets?*
Vet Name Vet Office Name Vet Phone Number
Have you ever been guardian to any animals that were:*
- Killed by moving vehicles
- Given Away
- Lost or Stolen
- Surrendered to Shelter or Rescue Group
- None of the above
Please explain the circumstance for the above checked answers.*
Do your own or rent your home?*
- Own
- Rent
If you rent, please give the name and telephone number of the landlor or rental agent so we may verify guardianship is permitted.*
Name Rental Agency Phone Number
Does anyone in your home have allergies to cat dander or saliva?*
- Yes
- No
Will someone be home during the day?*
- Yes
- No
People who will be home*
How long will the cat be home alone?*
Where will the cat be during*
Day Night When You Travel
Will you let the cat outside?*
- Yes
- No
How will the cat be outside?*
- Attended
- Unattended
- On Deck Only
- On Leash Only
- Fenced In Backyard Only
- Balcony Only
- Screened Porch Only
- Free Roaming
What are your thoughts on declawing?*
We hope to place cats into caring homes for the rest of their lives which could be up to 20 years. Are you willing to make this commitment?*
- Yes
- No
What will happen to the cat in the following situations?*
If You Move If You Move To A Place That Doesn't Allow Cats
What kinds of behaviors do you find unacceptable and how would you handle them?
Behavior Response
Do you believe in spaying and neutering your pets?*
- Yes
- No
Why not?*
What would cause you to return this cat to Animal Allies?*
Consent*
I am at least 21 years of age
Consent*
I agree to the privacy policy.
Privacy Notice

This privacy notice discloses the privacy practices for Animal Allies. This privacy notice applies solely to information collected by this website. It will notify you of the following:

1. What personally identifiable information is collected from you through the website, how it is used and with whom it may be shared.
2. What choices are available to you regarding the use of your data.
3. The security procedures in place to protect the misuse of your information.
4. How you can correct any inaccuracies in the information.

Information Collection, Use, and Sharing
We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.

We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to mail pet records to you.

Your Access to and Control Over Information
You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address on our website:

1. See what data we have about you, if any.
2. Change/correct any data we have about you.

Security
We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.

Wherever we collect sensitive information (such as personally identifiable information), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a lock icon in the address bar and looking for "https" at the beginning of the address of the Web page.

While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, contacting you regarding an application) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.

If you feel that we are not abiding by this privacy policy, you should contact us immediately via email.
CAPTCHA

Type of animal (dog, cat, other)	Name of pet	Sex	Age	Spayed/Neutered (Yes/No)	How long in your care	Indoor/Outdoor pet	Where is the pet now?

Vet Name	Vet Office Name	Vet Phone Number

Name	Rental Agency	Phone Number

Behavior	Response