Colony Caretaker Form

Feral Cat Colony Caretaker Form

Information is not to be shared publicly- this is only for research and keeping track of the population.
General Information

Currently only accepting information for caretakers residing in Walworth, Jefferson, and Rock Counties!
Name of Applicant*

First NameLast Name
Age of Applicant*
Applicants must be at least 21 years old to adopt
Email Address*
example@example.com
Cell Number*
Alternative Phone Number
Employment*
If Retired, write Retired.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home & Family

This is just to get an ideal of the support system you have!
Describe your home*

Single-FamilyApartmentCondo/DuplexPublic HousingTrailer/Mobile Home
Do you own or rent your home?*

OwnRent
If you rent, does your landlord know you feed? Please note: Your landlord will NOT be contacted. This is to show how many people feed "under the radar"
Who else lives in the home? If you live alone, just put "alone". *
Ex: husband, number of kids, etc.
Cat Colony Information
How many cat colonies are you feeding? 1 cat colony = 1 location. Some individuals feed multiple cat colonies spread out across a few different locations.*

1234+
What is the physical address in which the cat colony resides?*
Ex: Colony 1 is at ____________. Colony 2 is at __________.
How long have you been feeding your colony/colonies?*

Less than a year1-5 years5-10 years10+ years
How many cats do you feed total?*
How many cats would you say are socialized/friendly?*
How many cats would you say are feral/unfriendly?*
Approximately how old are the cats?*
Do not include cats that are currently on the schedule to be fixed
How many cats are already spayed/neutered?*
Do not include cats that are currently on the schedule to be fixed
Do you see new litters every year?*

YesNo
How average, how much do you spend each month on food?*
Are you currently working with a Trap-Neuter-Return program?*

YesNo
If yes, please name the TNR program you're using. If no, please briefly explain why.*
Do any of the cats have microchips?*

YesNo
Do the cats have ear-tips to show they have been spayed/neutered?*

YesNo
Do you have an established routine for cleaning the feeding and water bowls to prevent pests or disease? *
Do your neighbors know you feed? If so, are they for, against, or neutral? (Basically assessing overall neighborhood perspective to feral cat colonies)*
How often do you have new cats show up? What do you do when a new cat shows up?*
What have you done in the event of a cat being sick or injured?*
Ex: Taken to vet for medications, left it as is, surrendered to shelter/rescue, etc
What would you say is your biggest challenge(s) as a colony caretaker?*
If you have to leave town, urgently or planned, do you have someone who would take care of your colony?*
If you were no longer able to care for your colony, or had to move, what would happen to your colony?*
What else would you like to report about your colony(colonies)?*
Would you be willing to provide names, descriptions, and/or photos of the cats? If yes, please email them to journeyhomeanimalcontrol@gmail.com or find us on Facebook and message us there.*

YesNo
Veterinarian

Please list your current / previous / planned veterinarian(s) and any feedback you may have
Vet Clinic*
Does the vet clinic work with you on managing your cat colony (i.e. lowered spay/neuter rates for feral cats, safe handling protocols for feral cats)? If anything could change, what would you like to see more help with?*
Please note: If you say you'd like to see lower costs, please state what you feel like is reasonable to pay to have a feral cat spayed/neutered.
Additional Questions
Are you willing to report either annually or semi-annually to Journey Home on (1) the location of the colony, (2) the number and gender of the cats in the colony, (3) the number that died or otherwise ceased to be part of the colony, (4) the number of kittens born to colony cats and their disposition, (5) the number of cats placed in animal shelters or in permanent homes as companion cats, (6) the number of cats vaccinated, (7) the number of cats microchipped, and (8) the number of cats spayed or neutered?*

YesNo
If yes, how would you like to be contacted by Journey Home?*
Ex: email, texting, mail, etc
Would you like to be notified if there are any changes to ordinances in your municipality that may affect your cat colony directly?*

YesNo
Would you like to be notified if there is a missing cat in your area?*

YesNo
If yes to either of the above questions, how would you like to be notified? *
I, the undersigned, certify that the information provided in this application is complete and truthful to the best of my knowledge. I understand that my name and the location of the cat colony (or colonies) I feed will remain confidential and will not be publicly shared. I acknowledge that Journey Home is compiling information on local cat colonies and may use the information provided for organizational purposes as they determine appropriate.
Caretaker Name*

First NameLast Name
Signature*

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Date*

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Feral Cat Colony Caretaker Form

General Information

Home & Family

Cat Colony Information

Veterinarian

Additional Questions