Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
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(###)
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####
Email
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Best way to reach you
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How did you hear about our Barn Cat program?
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How many cats are you interested in adopting?
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What type of cats are you interested in?
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Sex
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Tell us why you want barn cats
Property location where the cats will reside
Do you:
If other, please explain
If renting, name and phone number of landlord
Volume of road traffic
Speed limit (mph)
Are you going to be the primary caregiver of the barn cats on your property?
If no, please explain
Have you ever had barn cats at this location before?
Do you have barn cats at this location currently?
How many?
If so, have all the cats been spayed/neutered?
Did you previously have barn cats that are deceased?
How long did they live with you?
What happened to them?
Do you agree to trap and take to the vet a barn cat who becomes ill or injured?
Have you had pets before?
Do you have pets of your own at this time?
Please fill in the following information for each pet you have:
Pet’s Name
Breed
Age
Sex
Spayed/Neutered (yes/no)
Lives Inside, Outside, or Both
Where Did You Get This Pet?
Years Owned
If you have a dog, is he/she permitted to run loose?
If yes, what provisions will you supply to protect the cats?
What type of shelter is available for the cats on your property?
Other
Are these outbuildings heated in the winter?
Secure confinement area?
Do you have a secure confinement area where the newly relocated cats can be kept safely for the first 4-5 weeks while they adjust to their new home (confinement areas must include windows or other amenities that allow cats to see and smell outside)? Briefly describe:
A site inspection may be required. We require photos of your confinement set up during the approval process. Are you able to provide this?
Are you able to provide and clean a litter box during and after the confinement period?
Can you provide food and fresh water for the cats on a daily basis for their lifetime?
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Are you willing to feed the cats canned wet cat food during and after the confinement period (this helps bond the cat to you and their new home)?
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How will the cats be cared for when you or the primary caregiver travels away from the home?
Describe any events that could prevent you from keeping these cats for their lifetime:
Supplies
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Are you aware of the supplies that you will need to have for the 4-5 week confinement period (weatherproof cage, coyote-proof cage, cat litter, litter box—one per cat, litter scooper, dry and wet food, fresh water, ant-proof bowls/dishes, bed, and blankets)?
Are you able to provide these supplies?
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Comments or Questions:
The cats have been spayed or neutered, vaccinated for rabies and FVRCP, ear tipped and microchipped.
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I am willing to make a $75 per cat donation to help Lincoln Terrace Park Cats with supplies and gasoline.
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Lincoln Terrace Park Cats cannot guarantee cat temperament. Feral cats may turn out to be friendly and semiferal cats may turn out to be unfriendly.
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I am over 21 years of age.
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I will not let any child under the age of 13 provide daily care to the cats I adopt.
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I have knowledge and consent of all adults in the household.
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I have the property owner or landlord’s consent to bring the cats to live on the property.
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I agree to a site inspection (may be virtual depending on location) to ensure a secure area and safe transition for the cats).
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I will provide the cats a dry, safe shelter with adequate warmth during the winter months.
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I will provide an adequate amount of nutritious cat food and clean water on a daily basis.
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I will monitor the health and safety of the cats and vaccinate the cats if needed. I understand that LTPC can loan me traps to take the cats to the vet.
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I am financially able and willing to pay for veterinary expenses in emergency situations.
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If a cat strays prior to being thoroughly acclimatized or has difficulty finding its way back to my barn/enclosure, I will continue to set out food and water to encourage the cat to stay close. I will also sprinkle that particular cat’s used litter (specifically feces) around the property to help lure the cat back to its territory. I understand cats often hide for a period of time but usually stay on or near premises.
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I understand that barn cats sometimes will not stay at their rehoming location. I agree to keep feeding cats for several weeks, even if I do not see the cats, to determine whether they have actually left the area.
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If I have to move and cannot take the cats with me or become unable to care for the cats in any way, I will contact Lincoln Terrace Park Cats.
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I will not give away, sell, relocate, or otherwise forfeit the care of these cats without consulting with Lincoln Terrace Park Cats.
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I will be financially responsible for any borrowed equipment not returned to Lincoln Terrace Park Cats within 30 days of adoption.
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Personal or Property Damage and/or Injury
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I agree that accidental animal bites or other injuries to humans and other animals do occur, and I agree to hold harmless and indemnify, and protect Lincoln Terrace Park Cats Inc. from any claim or suit filed by someone as a result of such incident.
In addition, Lincoln Terrace Park Cats Inc. will not be responsible if an animal should damage or destroy property belonging to caregiver, caregiver household, or others, or if the animal shall transfer any disease, internal or external parasites to other animals and people in caregiver's household.
I understand that if I am approved for receive a barn cat, this declaration represents a legal contract between me as the home caregiver and Lincoln Terrace Park Cats Inc.
I understand that if I am approved to receive a barn cat, I must abide by this agreement and that this agreement applies to any and all animals that I receive from Lincoln Terrace Park Cats Inc. through the Barn Cat program.
By signing below, I acknowledge that the information provided on this application is correct to the best of my knowledge. If at any time the information I have provided changes, I will provide the updated information to Lincoln Terrace Park Cats Inc.
Signature
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First Name
Last Name
Date
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MM
DD
YYYY
