Name of the cat(s) you are applying for:
1st Choice        
2nd Choiceblank   
Would you consider a pair?    Please Select Yes No  

Occupation: blanks
Place of Employment:blank

Do you live in a:    Please Select House Apartment Condo/Co-op    
Do you:    Please Select Own Rent Live with Parents    
How long have you lived at your current residence? blanks
Do you have plans to move?    Please Select Yes No  
Are pets allowed?    Please Select Yes No    
Will you need to pay your landlord a pet deposit?    Please Select Yes No    
How much? $blank

Name of Landlord/Homeowner   First Name   Last Name 
Contact number  Area Code   Phone Number   

Do they all consent to a new cat:    Please Select Yes No    
Does anyone in your household have animal allergies:    Please Select Yes No    

Have your children ever been around cats?   Please Select Yes No Not Applicable  

Up to Date on Vaccinations:    Please Select YES NO    
Spayed/Neutered:    Please Select YES NO    

Is present cat(s) declawed?    Please Select YES NO    
If yes, Vet who performed the declaw surgery/when:     First Name   Last Name    Date      

What brand(s) of food do you feed your cat(s)? DRY         
WET (canned)?         

As an adult have you owned cats before?:    Please Select YES NO GREW UP WITH CATS    
What happened to your last cat?:    Please Select OLD AGE ILLNESS RAN AWAY GAVE AWAY SURRENDERED TO A SHELTER OTHER       
Other (Explain)        
In what year did this occur?    

Will this cat be for?:    Please Select COMPANIONSHIP CHILD AS A MOUSER    
Is the cat a gift?:    Please Select YES NO       
If yes, for whom?        
Is it a surprise?    Please Select YES NO    

Who will be the primary caretaker of this cat?      
On average, how many hours per day will the cat be alone?      

When you travel or go on vacation, what arrangements will be made for this cat?
   

Do you have the finances to provide daily food and yearly veterinary care?:    Please Select YES NO    
Do you own a cat carrier?:    Please Select YES NO       
If no, are you willing to get one?  Please Select YES NO    

Are you willing to have a litter box in the house?    Please Select YES NO    

Do you hope or plan to have this cat declawed?
YES, becauseblanks .
NO, because   blank   
MAYBE, because? blank
Briefly explain what it means to "declaw" a cat:   Type a label   

Will this cat be living:     Please Select INDOOR OUTDOOR BOTH    
Explain:blanks
In what areas of the house will the cat be allowed: blank   
Any area(s) of the house the cat is NOT allowed and why: blank
Where will this cat sleep at night:      

Ideally a new cat will be contained separately from the household and then gradually introduced to the family (humans, other pets). Is this something your able to do?
Explainblanks .

Where in your house might you be willing to start this cat out?: blank   

Sometimes adoptions do not work out or pets cannot be kept. Under what circumstances might you decide not to keep the cat?:

If, for any reason, you are unable to keep or care for this cat we would like to be notified and have the cat returned to us. Are you willing to do this?     Please Select YES NO    
Explain:      

Your Veterinarian/Veterinary Hospital Name & Contact #:   First Name   Last Name         Area Code   Phone Number   
Are records under a different name (please provide)blank   

Personal Reference (someone who knows you well and would be supportive of you adopting this cat): 
First Name   Last Name   
Area Code   Phone Number   
Relationship:   Type a label