What is the name of the cat/ kitten(s) you are interested in adopting? First and Last Name* Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email* Best time to call? Are you 21 years or older?*If no, a parent/ guardian must complete the application Yes No Why do you want to adopt this cat/kitten?* How long have you been planning to adopt?* Please list all companion animals currently living in your household, including name, species, breed, sex, and age.*Write "no current companion animals" if you do not have any Are your current companion animals spayed/neutered?* Yes No List all companion animals previously cared for but no longer living with you. Please include species, age, and explanation for what happened to them (e.g., died of old age, euthanized, accidental death, re-homed, took to shelter, etc)*Write "no previous companion animals" if you've never had any Please list the name and phone number of all veterinary clinics that have cared for your companion animals in the last 10 years.* May we contact these veterinarians for past history?* Yes No Will this cat/kitten be kept indoors/outdoors?* Indoor only Outdoor only Both indoors / outdoors How do you feel about declawing?* Are you going to have this cat/kitten declawed?* Yes No Not sure What type and brand of food do you plan on feeding this cat/kitten?* Do you work outside of the home?*YesNoStudentRetiredDo all the members of your household know and approve of this adoption?* Yes No Does anyone in your home suffer from asthma or allergies to cat fur/dander?* Yes No I don't know Please list the ages of any children in your home* If you move or travel, what will happen to this cat/kitten?* What type of residence do you live in?*ApartmentTownhouseCondoHouseOtherDo you own or rent?*Please note, if you rent we will require permission from your landlord allowing this adoptionOwnRentOtherIf renting, please give your landlord’s name and phone number: Are you willing to have a NAfA representative do a home visit by appointment?* Yes No Do you understand the responsibilities involved with living with a companion animal, for example: providing a proper diet, and the cost of supplies, medical care, yearly veterinary checks, etc.?* Yes No Are you willing to make a commitment to this cat/kitten for the rest of his/her life (15-20 years)?* Yes No By submitting this application, I certify the information given is true, and I understand that Niagara Action for Animals reserves the right to deny my application for any reason at any time.* Agree Disagree