Adoption Application LinkedInThis field is for validation purposes and should be left unchanged.Email: leslie@uncommonhound.com Please fill out the form to the best of your abilities. All kittens and cats adopted out by Uncommon Hound Charities are spayed and neutered, have received their first round of vaccinations including a 1 year rabies, and have been treated with a flea/deworming treatment. An adoption fee of $150 helps cover these costs. Pet InformationCat Name(Required)ColorsMale or Female Male Female Applicant InformationName(Required) First Last Birth Date(Required) Physical Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) VeterinarianVeterinarian NameVeterinarian PhoneCurrent PetsDo you own pets now?(Required) Yes No Please list your current petsBreed & Name of AnimalFixed? (Yes/No)Vaccinated? (Yes/No) Add RemoveBreed & Name of AnimalFixed? (Yes/No)Vaccinated? (Yes/No) Add RemoveBreed & Name of AnimalFixed? (Yes/No)Vaccinated? (Yes/No) Add RemoveBreed & Name of AnimalFixed? (Yes/No)Vaccinated? (Yes/No) Add RemoveHouseholdDo you own or rent your home?(Required) Own Rent Landlord NameLandlord PhoneAre you willing to undergo house inspections?(Required) Yes No Do you have any allergies?(Required) Yes No Please specify your allergiesAdopter AgreementI (Adopter) hereby swear and attest that the following information is true and will be followed to the best of my abilities concerning the adoption of the pet listed above (hereafter referred to as “the pet”):I am adopting the pet solely as a domestic pet for myself and/or my family.I will not use the pet for any illegal activity including fighting.I will keep my pet up-to-date on all needed vaccinations, give adequate food, water and shelter.I will never let my pet outside to roam freely.I will pay the adoption fee to cover deworming, neutering/spaying, first vaccinations and deworming.I understand that no guarantee is made regarding the health or temperament of this pet.I understand that the rescue is not liable for any action taken by the pet. If the adoption does not work out, I agree to offer the pet back to the rescue before seeking other placement.I agree to not declaw my pet. Declawing is amputation of the last toe bone and can cause lifelong pain and problems. Adoption Fee: $150Agreement(Required) I have read and agree to all of the statements above. Adopter Signature(Required)Type your full legal name as your electronic signature.Date(Required) Uncommon Hound Charities (Rescue) attests to the following information as being factual:We will provide the pet with vaccinations and disclose them in writing at the time of adoption. We have been upfront with the Adopter about any known health issues the pet has, as well as any medication required. We have made no misrepresentations regarding temperament, age or medical status of the pet.The rescue signature, vaccination record and adoption fee are completed on the printed agreement at the time of adoption. Δ