Victoria County SPCA Serving Plaster Rock, Perth and surrounding areas

Adoptable Cats
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Pre-Adoption Application

"*" indicates required fields

Please note that approval for adoption does not guarantee you'll get the animal of your choice. we try to match each animal with its new owners based on criteria such as behaviour, activity level, and temperament. The Victoria County SPCA reserves the right to refuse any application if it believes it is not in the animal's best interest.

Name*

First Last

Address*

Street Address Address Line 2 City Province Postal Code

Home Phone*

Cell Phone

Email*

Are you interested in a specific VC SPCA stray? If yes, please share his/her name.*

Your Family

Number of adults (18 + years) at home*

Number of children (8-17 years) at home*

Number of children (0-8 years) at home*

Are you planning on the following in the next month?

Moving?

Holiday?

Your Home

What type of home do you live in?*

Rural House

Urban House

Rent

Own

How long have you lived here?*

Do you have your landlord’s/condo’s permission to have pets?

Yes

No

Landlord's Name

First Last

Landlord's Phone

Where will your animal stay during the day/night?*

Loose in the house

Garage

Fenced kennel/run

Crate/cage inside

Fenced yard

Loose outside

General Information

Who will have the primary responsibility for this animal?*

Have you had animals before?*

Yes

No

What happened to them?*

Have you surrendered or given away a pet?*

Yes

No

If yes, please provide the reason:

Are you prepared for the expense of routine care, annual examinations and emergency medical care possibly for the next 10-15 years?*

Yes

No

Your Pets

Are there other animals in your household?*

Yes

No

Please list your current pets, their gender, spay/neuter status and the date of their last vaccinations:

Please provide the name and phone number of your vet:*

*Please advise your vet that we will be contacting them and that they have permission to release information to the Victoria County SPCA.

Tell Us What You Are Looking For

Type of Animal*

Dog/puppy

Cat/kitten

Rabbit

Other

Sex*

Female

Male

Either

Problems you are willing to work on:*

Separation anxiety

Excitability

Mild aggression

Obedience

House training

Fearfulness

Reaction to other animals

Barking

I am not willing to work on any problems

I need more information to decide

I would like my animal to:

Be friendly with children*

Very important

Quite important

Not important

Be friendly with other animals*

Very important

Quite important

Not important

Enjoy being held*

Very important

Quite important

Not important

Enjoy being petted*

Very important

Quite important

Not important

Never show aggressive behaviour*

Very important

Quite important

Not important

Some Animals Require Training

Under what circumstances would you return your animal?*

Moving

Too costly

New baby

Aggression

Medical reasons

Not enough time

Behavior problems

None of the above

Comments

Have you ever been convicted of neglect or cruelty to animals?*

Yes

No

FALSIFIED INFORMATION WILL LEAD TO AUTOMATIC REJECTION OF THE APPLICATION. THE VCSPCA RESERVES THE RIGHT TO REFUSE ANY APPLICANT.

I understand that it is my responsibility to see and evaluate the animal for myself before agreeing to adoption. The adoption of a lifelong animal friend should not be impulsive, but rather a carefully thought out decision, which will ensure a loving, lasting relationship.*

I understand.

Please Provide 2 References:

Reference #1 Name*

First Last

Reference #1 Phone*

Reference #1 Address*

Reference #2 Name*

First Last

Reference #2 Phone*

Reference #2 Address*

Please advise your vet that we will be contacting them and that they have your permission to release information to the Victoria County SPCA. I grant authorization to release personal information pertaining to your history of pet care and your ability to care for your pet(s):

Name*

First Last

Date*

MM slash DD slash YYYY

Please feel free to make any comments that you feel are important for us to know:

Additional Information

Office Use Only

Interviewed by

Approved by

Denied by (reason)

Name

First Last

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