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: Astrid Blu Caramel Catarina Creamy Everest Hendrix Henry Hubert Jagger Jet Jimmy Josie Karat Kenny Kevin Kittens!!!! Kiwi Lorelei Luke Macie Mango Midnight Miso Oliver Ophelia Oreo Pepper Purrari Q-Tip Roxie Simba Stew Tiny Ziki

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?*