Adoption Application

Step 1 of 6: Personal Information

Have you adopted from Simba’s Sanctuary previously?

Yes No

First Name

Last Name

Date of Birth

Email address

Primary Phone

Secondary Phone

Preferred Method of Contact:

Primary Phone Secondary Phone Email Any

How did you hear about us?

I am presently:

Employed Full-time Employed Part-time Unemployed Retired Student

Are you adopting for your own household? If no, please explain:

Step 3 of 6: Current and Previous Pets

Have you lived with a cat before?

Yes No

Please provide information on each animal you currently own (Pet Name, Species, Age, Gender, Spayed/Neutered yes-no, Declawed yes-no):

+ Add Pet

If any of your pets are not spayed/neutered, please explain why:

Please list all former pets you have owned in the past 10 years (Pet Name, Type of Pet, Age, and why you no longer own this pet):

+ Add Pet

Have you ever had to surrender a pet? If yes, please explain why:

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Step 4 of 6: References

Have you used a veterinarian in the past 5 years?

Yes No

Do we have permission to contact them?

Yes No

Veterinary Reference:

Practice Name:

Phone Number:

Under what owner’s name are your pets’ records listed:

Personal Reference #1 (must be an acquaintance and not a relative):

Name

Relationship to you

Phone Number:

Personal Reference #2 (must be an acquaintance and not a relative):

Name

Relationship to you

Phone Number:

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Step 5 of 6: Desires and Expectations

Step 6 of 6: Terms & Release

If approved, if for any reason you are no longer able to keep the cat, the cat MUST be returned to Simba's Sanctuary?

I Agree I Disagree

I hereby grant permission for any veterinary practices listed above to speak to an employee/volunteer of Simba’s Sanctuary to discuss information related to the ownership and care of my pets.

I Agree I Disagree

I certify that all of the above information is true and accurate. I understand that if I adopt a pet from Simba's Sanctuary, this document will become part of the adoption record. I also understand that completion of this questionnaire does not guarantee the adoption of a cat from Simba's Sanctuary.

I Agree I Disagree

Back Submit Application

Thank you, your application has been submitted successfully.
We will review your application and reach out
to you as soon as possible.

Step 1 of 6: Personal Information

Step 2 of 6: Household Information

Step 3 of 6: Current and Previous Pets

Step 4 of 6: References

Step 5 of 6: Desires and Expectations

Step 6 of 6: Terms & Release

Adoption Application

Thank you, your application has been submitted successfully. We will review your application and reach out to you as soon as possible.

Step 1 of 6: Personal Information

Step 2 of 6: Household Information

Step 3 of 6: Current and Previous Pets

Step 4 of 6: References

Step 5 of 6: Desires and Expectations

Step 6 of 6: Terms & Release

Thank you, your application has been submitted successfully.
We will review your application and reach out
to you as soon as possible.