Working Cat Application

Name

First NameLast Name

Home street address

City

State

Zip code

County

Phone

Phone type

MobileHomeWork

Alt. phone

Alt. phone type

MobileHomeWork

Email

example@example.com

Will the cat(s) reside at your home/residence or business?

BusinessHome/Residence

If the cat will live at your home/residence, please provide your date of birth and driver's license #:

DATE OF BIRTH

DRIVERS LICENSE #

Do you own or rent?

I own this homeI rent this home

Has the property owner given permission to adopt a Working Cat?

YesNo

Who will be responsible for the care of the cat(s) once your lease has completed?

If the cat(s) will live at your place of business, please provide the business name and complete address:

Business name

Business street address

City

State

Zip code

County

Business/Non-Resident Applicants Only:

How often are you or another caregiver absent from the property?

All Applicants Please Answer the Following Questions:

Please describe the property where the cat(s) will live? E.g. Barn, home, warehouse, brewery, etc.

How large is the property?

Is the property heated?

YesNoPartially

How far is the property located from a main road?

Do other animals reside on the property and what type?

If home/residence, list your past pet history (please include the outcome of each animal):

Please describe what the cat(s) will use as primary shelter after the acclimation period:

Have you ever owned a "Working Cat" before?

YesNo

Why do you want a Working Cat?

Do you agree to trap and provide medical care should the cat(s) become ill/injured?

YesNo

How many cats are you able to accommodate? We prefer to place cats in groups of 2, or more, unless there is a cat that needs solo placement:

I have read the questions above and certify my information is complete and true. I understand providing false information may void my application. I authorize BARCS to verify the information provided. I also understand that BARCS reserves the right to deny my application:

PRINT NAME

SIGNATURE

FOR OFFICE USE ONLY

Check jurisdiction on property search

initials/date

Check for CSR or AC verification

initials/date

Check for PetPoint DNA

initials/date

Additional notes

Application approved

Working Cat Program Adoption Application