First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone

Alt Email

Have you ever adopted an animal from a rescue/animal control agency?*
Choose one: Yes No

Have you ever had an application rejected for adoption of an animal from a rescue/animal control facility?*
Choose one: Yes No

If yes, please explain

Why do you want to adopt a cat?*

What do you think are the most important responsibilities in owning a cat?*

If a disciplinary or behavior problem arises, what steps will you take to work on it?*

Any member of the family have any allergies to animals?*
Choose one: Yes No

Please explain

For whom are you adopting the cat?*
Choose one: Self Gift Child

Have you ever owned a pet before?*
Choose one: Yes No

Describe those pets you still own, including Name, Type, Age, Sex (spay/neuter?) and Comments (e.g. indoor/outdoor?)*

Describe those pets you no longer own including Name, Type, Sex (spay/neuter?) and Comments (where are they now? Date and age at death/giveaway?)*

List name & phone number of each vet where your animal(s) received care over the last 10 years: Clinic name(s): Doctor(s): Phone number (inc. area code) for each: What owner name(s) are records listed under: Date of last vet visit:*

Do you have a different vet in mind for your new pet?*
Choose one: Yes No

If yes, who?*

How much do you expect vet care, food, litter will cost annually?*

What kind of food do you plan to give your cat?*

Where do you plan to put the litterbox?*

How many people currently reside in your household?*

Any children in the household?*
Choose one: Yes No

If yes, please list ages

Who will feed the cat and clean out the litter box?*

Are you planning on declawing?*
Choose one: Yes No Not Sure

Where do you live*
Choose one: Apartment Condo Condominium Duplex House Mobile Home Townhouse

Do you own or rent your residence?*
Choose one: Rent Own

If rent, name of landlord and phone number?

Are pets allowed?*
Choose one: Yes No Not Sure

Is there an additional charge for pets?*
Choose one: Yes No Not Sure

Where will the cat be kept?*
Choose one: Inside Only Outside Only Inside and Outside

Will anyone be home during the day?*
Choose one: Yes No

How many hours will the cat be left unattended?*

When no one is home, where will the cat be kept?*

When you are home, where will the cat be kept?*

Where will the cat sleep?*

How frequently do you make business/vacation trips?*

What will you do with the cat when you travel?*

If you move, what will you do with the cat?*

Are you or your spouse with the military?*
Choose one: Yes No

Are you aware of our spay/neuter policy (requires that all dogs/cats in household be spayed or neutered)?*
Choose one: Yes No

Are you aware of the adoption fees (single kitten or cat $150 nonrefundable donation)?*
Choose one: Yes No

Please list what kind of routine veterinary care you plan to provide for your cat (including flea control, shots, etc., if known)*

Are you financially capable of taking care of the cat, including quality food, regular veterinary care, and emergency/elective veterinary care when necessary?*
Choose one: Yes No

A well cared for cat may live into its late teens or beyond. Are you willing to keep the cat as a member of your family for that length of time?*
Choose one: Yes No

Are you familiar with your local animal control laws?*
Choose one: Yes No

Are you willing to sign legal pet adoption papers?*
Choose one: Yes No

Are you willing to work with a "special needs" cat (one that is adoptable but may require extra time, patience or care to acclimate to a new home)?*

Please list any preferences you have in adopting a cat (age, sex, breed, personality):*

Which cat(s) are you interested in?*
Choose an animal: Altair Andy Atlas Bobby Charlie Chloe Clara Cooper Dapper Dobby Dottie George Goose Greg Griffin Jack Jackson Jewel Johnny Katie Kelly Kittens!!!! Loki Marcia Matcha Matilda Max Merry Mia Michele Minerva Mo Mr. Bean Noah Nolan Orion Paprika Paula Peter Petey Phoenix Pippin Ranger Red Ringo Robin Romy Sam Smudge Soba Sushi Tavi Udon Valkyrie Wasabi Zoe

Is there another cat you are interested in?*

Do you have any comments for us?

I pledge that the above information is true and complete. Further, I give permission to contact my landlord and my veterinarian (as appropriate). Please enter your full name and the date as your electronic signature.*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

How many kittens are you interested in adopting?*