Canterbury and District Animal Centre - Cat Adoption FormHow did you hear about the Animal Centre?Adopters InformationTitle(Required)Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneMobile Phone(Required)Email(Required) Enter Email Confirm Email You are looking to offer a home to:(Required) An adult cat A kitten Two adult cats Two kittens Alternative lifestyle (Farm cat) / lodgerMy ideal cat would be…..Home LifeHow many people live in your household?(Required)Please enter a number from 1 to 20.Adults:Please enter a number from 1 to 20.ChildrenPlease enter a number from 0 to 20.Ages of childrenIs the above address:(Required) House Maisonette Bungalow Flat Mobile home OtherIf you live in a flat, what floor is it on?How many rooms are in your home (excluding bathrooms):(Required)How many storeys in your home:(Required)Do you have a spare room/den area which could be dedicated solely to the cat’s use during the first few days of the cat settling in? This simply acts as a safe space whilst they adjust and can gradually be introduced to the rest of the property as their confidence blossoms. If so, which room of the house?(Required)Is the above address: (If a tenant, proof will need to be shown that pets are allowed)(Required) Private Tied Private rent HM Forces Council/Housing trustPlease provide your proof below (If applicable)If you are having trouble uploading, please email this to info@rspca-canterbury.org.uk Drop files here or Select filesMax. file size: 256 MB. Is there access to a private garden?(Required) Yes NoWhat size is your garden: Small Medium Large Extra largeDo you have a cat flap fitted? Yes NoWhere is the cat flap located and what type of cat flap is it?Is the accommodation on: Quiet road Cul-de-sac Road with rush hour traffic Busy main road Backing on to a railway lineIf you have photos of your home and garden, please upload them using the option below. This will act as a virtual home visit.If you are having trouble uploading, please email this to info@rspca-canterbury.org.uk Drop files here or Select filesMax. file size: 256 MB. Is there likely to be a significant change to your routines in the next 6 months (new baby, moving house etc.)Are you going on holiday? - If yes when and how long for:Are there any children that regularly visit the property? - If yes who, why and how often? Please give ages.Are there any members of the household that are allergic to cats/cat hair? - If yes, who and how serious is the reaction?Do you or another member of your household currently smoke?Working LifePlease describe your working pattern:Please describe the working pattern of any other members of the household:On average how long would your cat be left on its own and why?Experience and other petsHave you owned a cat before? - If yes how long for and what happened to them?Where did you get the cat?Do you have any other pets? (cats or other species) - How many other pets:Please describe your other pets (for example breed, age, sex, neutered):Please describe the temperament of your existing pets:Have existing animals lived with cats before?If yes, please describe how your pet behaves around cats:How “cat” populated would you describe your neighbourhood? 0 1-5 5-10 10+Have any of these cats gained entry to your home at any time? If so please describe:Are all existing animals up to date with routine vaccinations? (Proof of vaccination must be seen before adopting a cat)Please upload proof of vaccination recordsIf you are having trouble uploading, please email this to info@rspca-canterbury.org.uk Drop files here or Select filesMax. file size: 256 MB. Are all existing animals up to date with routine worm and flea treatments?Name and location of your veterinary surgeon:Are you happy for us to contact your vets?When you are away are you able to make appropriate cat sitting arrangements? Are you prepared to cover the cost of boarding your cat (approximately £10 per day) if necessary?(Required) Yes NoAre you prepared to seek veterinary advice on routine vaccinations, worming and flea control and to cover the costs incurred for treatment given? (Approx cost – Annual Booster £35/Worming and flea control £50 per year)(Required) Yes NoIn the event of a sudden change in circumstance or bereavement, would you have someone who is able to take over ownership of the cat / kitten?Which age bracket are you in?(Required) 18-25 26-35 36-45 46-55 56-65 66-70 70+Confirmation(Required) By ticking this box I confirm that the above information is truthful and correct
