ADOPTION APPLICATION

Name

Please ONLY type your FIRST and LAST name

Email Address

Cell Phone Number

Home Phone Number

Address

City

State

Zip Code

Driver’s License (number, state, expiration date)

Why would you like to adopt a rescued animal from Cage to Couch?

How did you hear about Cage to Couch?

Please tell us about any upcoming life events you are aware of, like travel, remodeling, medical procedures, etc., that could affect the application process and the ability to acclimate the C2C rescue to their new surroundings.

{name}

Do you have a specific Cage to Couch rescued dog or cat you’re applying to adopt?

Yes
No Preference

If so, what is his or her name?

Add

If you don’t have a specific Cage to Couch rescued dog or cat you’re applying for, do you have other preferences for adopting?

(Please check all that apply)

Are you hoping for any particular characteristics in the cat or dog you adopt?

(Housebroken, good with cats/dogs, good with children, etc.)

Would you consider adopting an animal with special needs? If so, please check below those that you would consider.

About You and Your Family and Home Are you 18 years of age or older?

(Adopters must be at least 18 years of age)

Yes
No

EMPLOYMENT STATUS

(Please check applicable status below)

How many hours each day are you away from home?

How many hours each day will your adopted dog or cat be without human company?

When you’re away from home, where will your adopted animal be? (i.e., in a crate, confined to an area in the house, in the yard)

When you go on vacation, who will care for your adopted dog or cat? (family, friend, pet sitting service, boarding facility, etc.)

Where will your adopted dog or cat sleep at night? (in a crate, on your bed, in his or her own bed, outside, etc.)

How many adults over 18 years of age, beside yourself, live in your home?

How many children live in your home? What are their ages?

Does anyone in your home smoke inside the home?

Yes
No

Which best describes your home type?

Apartment/Condo
House with fenced-in backyard
House with both front and backyard fenced in
House with no yard or no fence
Duplex/Bungalow

Do you own or rent your home? **If you rent your home, you will need to provide proof of allowance for animals. Proof can be mailed to: rescue@cagetocouch.org

Own
Rent

If you rent, does your landlord impose any breed or weight restrictions?

Yes
No

If yes, please explain

Do you have a pool?

Yes
No

If you have a pool, is there a fence around the pool?

Yes
No

Do you have a doggy door?

Yes
No

Do you have a housekeeper and/or gardener who comes when you’re not at home?

Yes
No

Have you fostered or adopted a rescued dog or cat in the past? If yes, please explain with which rescue/shelter, animals fostered, adopted, etc.

{name}

Do you currently have any other animals? Please list all current animals in your home, both indoor and outdoor, with species and ages.

{name}

If you have other animals, are all your animals spayed or neutered? If not, why?

If you have other animals, are all your animals current on vaccinations? If not, why?

If you have other animals, do you think they will accept a new furry family member?

Yes
No
No other animals

Have you had animals in the past? If so, please tell us about them.

{name}

For which of the following circumstances would you relinquish an adopted dog or cat?

(Select all that apply.)

Will you be willing to agree to return your adopted dog or cat to Cage to Couch if you decide, for whatever reason, to surrender the animal you’ve adopted?

Yes
No

Our adoption fees are below. Please initial that you are aware of the adoption fee. Dogs: $550 Cats: $125

Are you active on social media?

Yes
No

If yes, please include links to your profiles or your “handles” Facebook; Instagram; TikTok; Twitter

Please provide details of your regular veterinarian if you have one. Veterinary Clinic Name

Veterinarian’s Name

Clinic Telephone Number and/or email

Questions Specific to adopting a Beagle or a Hound Have you previously cared for a beagle or a hound?

Yes
No

If yes, please tell us the circumstances and your experience with the beagle or hound.

If no, what is your knowledge of the beagle breed or hounds?

Please initial below I’m aware that a beagle or hound cannot be off-leash outside the home/yard

Please initial below I’m aware that beagles can be vocal and may bay loudly

Please provide us two non-related references – name and phone number and/or email Reference 1 Name

Reference 1 Phone

Reference 1 Email

Reference 2 Name

Reference 2 Phone

Reference 2 Email

It may take some time for your adopted dog or cat to adjust to a new environment and may show anxiety by having accidents in the home and/or separation anxiety. Please initial below I understand time and patience are required

Please initial below I understand that any misrepresentation of the above information authorizes Cage to Couch to deny application, and/or reclaim the animal that is in my home.

I agree that the information contained in this application is true and correct at the time of this application. Name

Date

I have read and agree to the Terms and Conditions in the link below:

https://bit.ly/3iaLmVa

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