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First Name:
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Last Name:
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Name of Cat(s) you are interested in Adopting:
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Street Address:
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City:
Please enter your first name |
State:
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Zip:
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Phone: |
Work:
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Home:
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Email:
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Drivers License: |
State:
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Number:
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List all current pets that you have had in the past ten years in the table below.
This includes any pets living with you or pets that you have re-homed.
Also list all pets living in the home that may not be yours (roommate's pets, etc.) |
Type of pet |
Spayed or neutered? |
Indoor, outdoor or both? |
Living? |
If living, current on vaccines? |
If deceased, list cause of death |
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Do any of your cats currently spend any time outdoors? If so, please describe the circumstances.
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Why do you want to adopt a cat?
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List the ages of all of the members of your household:
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Who will be responsible for the day-to-day care of the cat?
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Do you have a regular veterinarian?
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How long have you been with this vet?
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Vet Full Name:
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Vet Address:
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Vet phone number:
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If no Vet Reference, please provide a reason:
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Do you own or rent your home?
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If renting, do you have your landlord's permission to keep a cat?
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Landlord's Full Name:
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Landlord's Phone:
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Other Animals in Home?
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Do you plan to move in the next 12 months?
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Some cats adjust to new homes, children, and/or other pets more easily than others. How much time do you have to spend with a new cat/kitten to help it adjust to your household?
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Cats can live quite long lives, are you prepared to provide a home for 10-15 years or more?
Please explain a 'no' or 'don't know' answer:
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When your cat is home alone, where will it stay?
Garage
One room in house
Basement
Run of the house
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Outdoors
Other: (Explain)
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What kind of lifestyle do your want your cat to live?
Strictly Indoor
Indoor / Outdoor
Mostly indoor with some outdoor |
Strictly Outdoor
What is the reason for this choice?
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Under what circumstances would you consider giving up your pet? |
Scratches the furniture
Having a baby
Getting a divorce or getting married
Sheds |
Fleas
Moving to another state
Found a new 'no pet' apartment
Too Expensive |
Finished school/moving back home
Children will no longer take care of it
None |
Other (please explain)
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If you have to go away on business or vacation, how will your pets be cared for?
Leave them alone with plenty of food/water
Pet Sitter
Friend or Relative check on them
Kennel/Boarding
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Other (please explain)
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Would you ever consider declawing your cat? If so, under what circumstances?
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How much do you estimate caring for your cat will cost each year, not including unexpected illnesses or injuries? (Mainly routine veterinary visits, supplies, food, toys, etc?
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How often do you think a cat should go to the vet for routine care?
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Please Provide 3 References: |
Name:
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Phone:
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Relationship to Applicant:
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Name:
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Phone:
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Relationship to Applicant:
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Name:
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Phone:
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Relationship to Applicant:
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How did you hear about our rescue efforts? |
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I am over 21 years of age |
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Please provide any other information you feel would be helpful to us in screening your application:
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