Adoption Application

Name of Cat(s) you'd like to adopt *

Name *

First

Last

Middle Intitial *

Your Date of Birth *

Email *

Receive e-mail from this organization?

• Yes
• No

Street Address *

City *

State *

Zip Code *

Mobile Phone Number *

Home Phone Number *

Employment Status *

• Employed
• Retired
• Student
• Unemployed

Employer

Number of people in household *

Ages of anyone in the house under 18 *

Is anyone in the home allergic to cats *

• Yes
• No

Type of Residence *

• House
• Condo
• Farm/Barn
• Apartment
• Mobile Home

If renting, are cats allowed?

• Yes
• No

Name and phone number of Landlord (required for rentals) *

Type of Street *Busy RoadResidential AreaSlight trafficCountry Road

Where will the cat live? *Inside onlyMostly insideOutside onlyMostly outside

Where will the cat stay at night? *

• Inside
• Outside

How many hours a day will the cat be alone? *

Where will the cat stay when home alone? *

Home activity level *Busy (visits by friends, meetings, children, parties at home)Noisy (TV, stereo, tools, children playing, dogs barking)Moderate (normal comings and goings)Quiet (homebodies, few guests)

Who will take care of the cat in the absence of the primary caregiver? *

In what circumstances would you return the cat? *

• New job
• Divorce
• New baby
• Move
• Illness of Cat
• If I develop a serious illness
• I would not give up the cat for any reason
• Other (explain below)

Other

Are you willing to take responsibility if the pet develops an illness? *

• Yes
• No

Are you willing and able to pay the veterinary costs of caring for your new pet? *

• Yes
• No

How much time are you prepared to allow for your new pet to adjust to your home? *

Do you plan to declaw your cat? *

• Yes
• No

Do you consider your cat a part of the family? *

• Yes
• No

Have you had pets in the last five years? *

• Yes
• No

Please list current pets, types and ages

Are all your pets spayed or neutered? *

• Yes
• No

Please list your last 5 pets and why they are no longer with you

Name of Veterinarian and Phone Number *

Adoption is a lifetime commitment. Are you prepared for this? *

• Yes
• No

Are you 18 years of age or older? *

• Yes
• No

Why would you like to adopt this particular cat? *

Full Names and Ages of All Adults in the Household *

Subscribe to our Quarterly Newsletter? *

• Yes
• No

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