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Cat Adoption Form

Humane Society of Freeborn County

Fill out the online application below,

or download a pdf version,

print and mail to:

P.O. Box 423
Albert Lea, MN 56007
(507) 377-7730

Cat Adoption Form

id
time_date
Name
Address
City
Zip Code
Phone Number
Note:

If you do not provide your phone number, your application will be discarded.
Best Time To Call
Email Address
Occupation
How long at present job
If less then 1 year please state how long at your previous job

Reference 1

Name
Relationship
Daytime Reference Phone Number
Evening Reference Phone Number
Best Time to Call Reference
Reference Email Address

Reference 2

Name
Relationship
Daytime Reference Phone Number
Evening Reference Phone Number
Best Time to Call Reference
Reference Email Address

Additional Information

Do you own or rent your home?
If renting do you have your landlords permission to keep a cat?
Landlords Name
Landlords Phone
Note

If renting, you will need to provide a copy of your lease or co-op bylaws to the humane society representative before adoption.
Do you live in a:
Note

If you live in a condo or co-op, our your house is part of a homeowner’s association, prior to adoption, you will need to provide a copy of the bylaws, rules and regulations of such association stating that there are no restrictions regarding owning a cat. If there is a limit on the number of pets you are allowed, please note the limit on the copy of the bylaws.
How long have you lived at this address?
If less than 1 year, please state how long at previous address.
How many adults in household?
How many children in household?
Ages of children
Are all family members in agreement about adopting a cat?
Are there regular visitors to your home, human or animal, with whom your new cat must get along?
If yes, please describe.
Do you own cats?
How many cats do you own?
Are they spayed or neutered?
Do you have other animals?
What other animals do you have?
Do you have a regular veterinarian?
Note:

If you currently own a pet or have owned a pet in the last 10 years, your vet’s name is required to process your application. If you cannot supply a vet reference, please give the reason why.
Vets Name
Address and phone
How long have you been with this vet?
The reason I cannot supply a vet reference is
How many cats have you owned in the last ten years?
For all cats you presently own, give name, age, sex, and if spayed or neutered:
Give name, age, sex, if spayed or neutered and what happened to all cats that you have owned in the past 10 years but no longer have, listing the years you owned them:
Where will the cat spend the day?
On average, how many hours will the cat spend WITHOUT human company each day?
Where will the cat spend the night?
Do you understand that the Humane Society of Freeborn County requires cats to be spayed or neutered?
Do you agree to license this cat and give it regular health care?
Do you agree to contact the Humane Society of Freeborn County if you can no longer keep this cat?
Would you be willing to allow someone designated by the Humane Society of Freeborn County to visit your home by appointment?
If not, why?
How did you hear about the Humane Society of Freeborn County?
I am over 18 years of age
If under 18, my parents are agreeable to my adopting this cat
The Humane Society of Freeborn County does ask for an adoption fee in order to help us cover expenses incurred.

All of the above information I have given is true and complete. Should an unneutered or unspayed cat be placed with me, I agree to have it neutered or spayed by such date agreed upon by the Humane Society representative and me. At that time, I will forward evidence to the Humane Society of Freeborn County that such procedure has been completed.

This cat will reside in my home as a pet.
I will provide it with adequate food, water, shelter, training, affection and medical care.
I understand that the Humane Society of Freeborn County is not responsible for the accuracy of information received about the habits, temperament or physical condition of cats available for adoption.
I understand that it is my responsibility to evaluate the cat for myself before agreeing to adopt it.
I am in full agreement with these terms of adoption.

The Humane Society of Freeborn County shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes of action, fines, suits, demands, judgments or claims of any nature whatsoever arising from or by reason of any damage to property or injury to any persons caused in whole or in part by the cat placed in your home.

I hereby accept and assume such liability and agree to protect, indemnify and hold the Humane Society of Freeborn County harmless from and against all of the aforesaid.

Submitting this form constitutes your permission for us to check references.

WE RESERVE THE RIGHT, IN OUR SOLE DISCRETION, TO REFUSE ANY APPLICANT FOR ANY REASON WHATSOEVER.
SIGNATURE: By entering your name here you agree to all of the information on this form.
Other comments:
Please Remember:

millions of cats are killed every year in shelters because they are not wanted. Please be sure that you are willing to have this cat as a pet for many years to come before adopting it.

Also, many of these poor souls are sent to research labs to have horrible tests done to them when shelters cannot keep them so if you ever need to find a new home for this companion animal, please return them to us and not take them to a shelter.
Date

Cat Adoption Form

Cat Adoption Form

Reference 1

Reference 2

Additional Information

Main Menu

507-377-8501