FEW STEPS FROM HOME CAT ADOPTION APPLICATION
Name of Cat applying for
*
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Date
*
-
Month
-
Day
Year
Date
Age
*
Do you work?
*
Yes
No
Retired
Describe what you do for a living? please type N/A if you do not work
*
Are you married?
*
yes
no
engaged
Other
Do you have experience with cats?
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Yes
No
Do you have children?
*
yes
no
planning to have them soon
Ages of children
Do your children have experience with cats?
*
yes
no
I do not have kids
What makes You want a cat?
*
Have you ever had outdoor cats?
*
yes
No
maybe
If you answered "yes" or "maybe" to the above question please expand on your answer.
What would present a problem for you? (please select all that apply)
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not using the litter box
clawing/sharpening nails on furniture
coughing up hairballs
clawing a person
vomiting
Tracking cat litter around home
Shedding
laying on furniture
What would you do if any of the above options presented a problem? Please explain in detail
Would any of these issues cause you to give up on your cat? If so, which ones?
*
How long will you give your cat to get used to his/her new surroundings?
*
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Next
Pets in Home
Please tell us what other pets are in your home
I currently have
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Cats
Dogs
Other
No Other animals
Please explain here about your other animals. Please list Type age, sex. If you do not have any other animals please type N/A
*
Are all your pets in the home spayed or neutered?
*
yes
no
no other pets
If You selected "no" please explain why
Are all of your pets updated on vaccines?
*
yes
No
No other pets
If You selected "no" please explain why
Do you keep your pets on Flea and tick prevention?
*
yes
no
No other pets
If You selected "no" please explain why
Are your pets used to being around other pets?
*
yes
no
no other animals
Please explain how if you currently have other animals you will introduce them?
*
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Next
Veterinarian Information
Please tell us about your veterinarian. PLEASE BE SURE TO GIVE YOUR VET PERMISSION TO SPEAK WITH US
Do you have a CURRENT veterinarian ?
*
yes
no
Clinic Name where pets have been seen in the last 3 years
*
Veterinarians Name
*
First Name
Last Name
Veterinarian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Veterinarian Phone Number
*
-
Area Code
Phone Number
What do you consider routine vet care for cats?
*
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Personal References
Enter Three Personal references here. These references can be friends, family, neighbors or coworkers.
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
How do you know this person and for how long?
*
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
How do you know this person and for how long?
*
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
How do you know this person and for how long?
*
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Signature
Please place your electronic signature on this page. We reserve the right to turn down any applicant as we see fit.
I am placing my electronic signature on this application by clicking the "agree" button. I agree that everything on this application is true and valid to the best of my knowledge. Should anything be falsified, this application will become null and void.
*
I agree
Submit
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