Parma Animal Shelter Adoption Inquiry Form KITTENS and CATS

Your name *

Street number & name *

City *

State *

Zip Code *

Home phone number *

Cell phone number *

Email Address *

I am interested in (check all that apply) *

Kitten (under 7 months) Cat (8 months - 8 years) Senior (over 8 years) Declawed Health issue Behavioral issue Hospice

If you are interested in a particular animal, please list the name(s) here

Do you rent or own? *

Rent Own

Provide landlord contact information: (if not applicable type NA) *

Do you have children in the home? If so, how old are they? (select all that apply) *

Under age 6 Ages 7-12 Over the age of 13 Not applicable

Other adults in the home? If so, who? If not, write NA *

How many cats are currently in the home ? If none type 0 *

How many dogs are currently in the home ? If none type 0

Are the other animals in your home spayed or neutered? If not, please explain. If not applicable, type NA *

Are you financially able to provide care (food, shelter, vet care) for your new pet? *

Explain your previous experience with cats. If none, type none *

What veterinarian will you use for the care of the animal ? If you do not already have a vet, type none *

Have you ever had to re-home a pet? If so, please describe the circumstances. If not, type NA *

Have you ever had to euthanize a pet? If so, please describe the circumstances. If not, type NA *

Under what circumstances would you consider giving up a pet? *

If you become unable to care for your new pet, please give the name and contact information for the person who will take responsibility for the animal. *

I plan to keep the adoptable cat: (please check one) *

Indoors only Outdoors only Both indoor & outdoors

Additional comments or questions

The Parma Animal Shelter, Inc. is a non-profit organization. Our animals are not for sale, they are for adoption, which means a home must meet the approval before adopting a pet, including, but not limited to, filling out this form, discussion(s) with an adoption counselor, meeting with the prospective pet and a signed contract. In addition, the Parma Animal Shelter, Inc., reserves the right to turn down a prospective adoption at any time during this process for any reason.

I will provide proper care and shelter. I will not abandon the adoptable cat(s)at any time. Cats over 8 months in “PENDING" status will be held for 72 hours, after which they are returned to the general population.

* A cat carrier must be used to transport the adoptable cat(s) home, if you do not have one, you maypurchase one from The Parma Animal Shelter for $5.00.

I assert that the information I have provided on this form is accurate and true, and have read and understand the above disclaimer. By typing my name here and SUBMITTING this application I understand that I am responsible for the well being of the adoptable cat(s). *

Your typed name serves as your signature.