Application Form - Animal Allies

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?*

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.

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Animal Allies Application