CAT Adoption Application

Name of Cat you're interested in adopting: *
Personal Information
Name*

First nameLast name
Street Address*
City*
State*
Zip code*
Cell Phone Number:*
Please enter a valid phone number.
Email address*
example@example.com
Do you work:*

Full TimePart TimeFrom HomeRetiredOther
Please provide any comments or explanation of your work schedule here:
Employer:
Work Phone:
Please enter a valid phone number.
Personal Reference:

First NameLast Name
Personal Reference Phone Number:
Please enter a valid phone number.
Home Information
What type of home do you have?*

HouseApartmentTownhomeMobile HomeOther
If "other" please describe:
Do you rent or own?*

RentOwn
How many adults live in your home?*
Name(s) of other adults in your home:

First NameLast Name
Ages of adults in home?
How many children live in your home?
Ages of children?
Will your cat be permitted outdoors?*

YesNo
If "yes", are there any direct threats to your cat outside (i.e. unfriendly outside pets, busy roads, wildlife, etc)? How do you plan to mitigate any of these risks to your cat's safety?
We do home checks for all of our adoptions. Do you have the ability to FaceTime if we are not able to do the home check in person?*

YesNo
Pet Ownership History
Do you currently own any other pets?*

YesNo
Please give name, breed, gender and age of each pet here:
Are all of your pets spayed or neutered?

YesNo
If answer is NO, please explain why not:
Veterinarian Office:
Veterinarian's Address:
Veterinarian's phone: (If you don't have a current vet, please provide a second personal reference)
Reference #2:

First NameLast Name
Reference #2 Phone Number
Type of flea/tick prevention you currently use, if any:*
Please list all pets that you have owned in the past 5 years:*
If you no longer have them, please give details explaining what happened to them:*
If you have ever put one of your pets up for adoption or had one euthanized, please provide details:*
I affirm that by submitting this application that ALL of the information on this application is true and complete, and that no one in the house where the pet will reside has ever been charged with or convicted of any type of animal cruelty.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Personal Information

Home Information

Pet Ownership History