NHCR Adoption Application

In the event the cat does not work out, the cat MUST be returned to NHCR.

Signing this application does not guarantee adoption nor obligate you to adopt a cat.
Applicants must be at least 21 years of age.

• Your Name
• Your Email Address
• Your Current Phone Number
• Your Work Phone Number
• Home Address
• City
• State
• Zip Code
• Do You Own? (Yes or No)
• If You Rent: List Landlord Name and Phone Number
• Are there children in the home? (Yes or No)
• If children in the home, list ages
• How many other adults live in the home, excluding applicants?
• Please list their names:
• Are they in agreement with this adoption? (Yes or No)
• Have you ever adopted a pet before? (Yes or No)
• Have you ever released an animal to a shelter? (Yes or No) - If Yes, please explain
• Does anyone in the home have pet allergies? (Yes or No) If yes, please explain
• Are you employed? (Yes or No) If Yes, list Employer & Employer phone number:
• If you are not employed, list source of income for pet care:
• Please list a non-family personal references - Name and Phone Number
• Please list a secondary non-family personal references - Name and Phone Number
• New Field 1
• Name of and number of current vet:
• List all animals living in the home in the last 5 years. Type of animal? Spayed/Neutered?
• List all animals in the last 5 years that are no longer living in your home and briefly explain the situation:
• Additional Comments:
• Type your name in the box (to act as your signature) and today's date