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Cat/Kitten Surrender Application

Please fill in the blanks, sign it, and click Submit. If we are able to accept your animal into our program you will be asked to pay a surrender fee of at least $50 per animal/litter. The surrender fee is a non-refundable fee used to help us cover our veterinary, food, shelter and other expenses for the cat. If we are able to accept the cat, the surrender fee can be paid by check at the time of acceptance or online.

Answers for all questions are required except for those marked as Optional. However, it is in your best interests to answer all questions about your cat so we can find a home for him/her!



First and Last Name:
Home Address (optional):
City (optional):
State (optional):
Zip Code (optional):
Home Phone:
Alternate Phone:
E-mail Address:
Cat's Name:
Cat's Age:
Spayed/Neutered:
Yes No
Breed/Mix:
Color:
Microchipped:
Yes No

Microchip #:
Are you the first owner:
Yes No
Declawed:
All four feet Front feet only Not declawed
Did you adopt your cat from HALO Animal Rescue:
Yes No
If not, what was the name of the rescue group/shelter:
Did you call the other rescue group/shelter for help finding a home:
Yes No
If yes, what was the response:
Why are you surrendering the cat/kitten:
How long have you owned the cat/kitten:
Did you try to find an alternative home before contacting HALO:
Tested for Feline Leukemia/FIV:
Yes No Leukemia only Unsure
If yes, were the test results negative:
Yes No
Veterinarian Name and Phone Number:
Does the cat/kitten have any physical issues/allergies:
Last Rabies Vaccine Date:
3-in-1 Vaccine:
Leukemia:
Brand(s) of food cat eats:
Daily amount of food eaten:
Fully Litterbox Trained:
Yes No
What would be the ideal home for the cat:
Good with strangers:
Yes No
Good with children:
Yes No
Good with cats:
Yes No
Good with dogs:
Yes No
List any bad habits:
Scratches:
Yes No
Sleeps with you:
Yes No
Allowed Outdoors:
Yes No
Bites:
Yes No
Hides:
Yes No
Most Appealing Traits:
 
For a stray or undomesticated cat/kitten, you are providing the following additional information, which you promise is true and correct on the date of this Agreement:

When/Where was it found:
Did it live in or around your home or elsewhere:
Any information about who might own the cat:
Is there any evidence that the cat/kitten is suffering from any bites, wounds or other injuries:
Scanned for Microchip:
Yes No
How did you hear about HALO?
What amount can you donate if we are able to take in this animal:
I understand by submitting this application, my information may be shared with other animal welfare organizations and rescue individuals in an attempt to accommodate my needs if HALO Animal Rescue is unable to do so.


Please click the Submit button only one time! It will take a few seconds for our system to process this form.



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