Pre-Adoption Application
Animal Interested in:
Name:
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone:
-
Area Code
Phone Number
Cell:
-
Area Code
Phone Number
Email:
example@example.com
Drivers License/ID#:
DOB:
-
Month
-
Day
Year
Date
Date:
-
Month
-
Day
Year
Date
YOUR FAMILY
1. Name of adults at home:
2. Number of children?
0-3 years
4-8 years
9-12 years
12-17 years
3. Any visiting children?
Yes
No
4. Any allergies in the family?
Yes
No
5. How busy is your family's schedule?
Very busy
Busy
Not busy
6. How would you describe yourself?
Nervous
Loud
Calm
Quiet
7. Are you planning on the following in the next month?
Vacation
Moving
Change in schedule
Weekdays:
Weekends:
8. Where will the cat stay during vacations/traveling?
At home with care
Boarding
Other
Vet/medical
Food
Boarding
Grooming
YOUR HOME
1. What type of home do you live in?
House
Apartment
2. Do you
Rent
Own
3. Do you have your landlord's permission to have pets?
Yes
No
Please list landlord's name and phone number or a copy of your lease agreement.
Phone number:
-
Area Code
Phone Number
Lease agreement attached
Yes, please initial
Other
GENERAL INFORMATION
1. Who will have primary responsibility for this cat?
2. Have you had cats before?
Yes
No
3. What happened to them?
4. Have you surrendered or given away a pet?
Yes
No
If yes, please provide the reason:
YOUR PETS
1. Are there other cats in your household? Yes No If yes, please list them:
Rows
Name
Breed
Age
Sex
Fixed?
1
2
3
2. Do you have any other pets in your household? Yes No if yes, please list them:
Rows
Name
Breed
Age
Sex
Fixed?
1
2
3
Weekdays:
Weekends:
5. Where will your cat stay during the day?
Loose in the house
Garage
Loose outside
Other
6. Where will your cat stay during the night?
Loose in the house
Garage
Loose outside
Other
3. Please provide the name and phone number of your vet:
Practice/Name of Clinic:
Phone Number:
-
Area Code
Phone Number
FOR OFFICE USE ONLY
Shown by:
Initials:
Staff comments:
Approved:
Yes
No
Pending
Reason:
Back
Next
TELL US WHAT YOU ARE LOOKING FOR
Sex:
Female
Male
No preference
Coat:
Short
Medium
Long
Non - shedding
No preference
Age:
Kitten
Adult
Senior
No preference
Size:
Small
Medium
Large
No preference
Breed/Type/Color:
Long term pet care
1. What will happen to this cat if you move?
2. Are you prepared to accept the cost of a cat in the home?
Yes
No
3. Are you current pets current on all vaccinations?
Yes
No
Not sure
Approximate date:
-
Month
-
Day
Year
Date
4. Will you be keeping the kitten/cat indoors on a permanent basis?
Yes
No
5. How do you plan on coping with furniture scratching?
6. Have you ever declawed a cat?
Yes
No
If yes, for what reason?
7. Are you aware of the dangers/concerns regarding declawing?
Yes
No
Rows
VERY IMPORTANT
IMPORTANT
NOT IMPORTANT
Be friendly with children
Be friendly with other cats
Be friendly with dogs
Be friendly with me
Be friendly with visitors in my home
Enjoy being groomed
Enjoy being held
Be calm
Be playful
Be quiet
Be independent
Never wake me up at night
Never show aggressive behavior
Under what circumstances would you return your cat?
Moving
Too costly
Aggression
Medical reasons
Not enough time
Behavior problems
Other:
Have all the members of your household met the cat?
Yes
No
Have you or anyone in your household, ever been convicted of neglect or cruelty to animals, or a violent crime?
Yes
No
If yes, when?
Explain
Are you willing to have a PAWS representative do a home visit by appointment?
Yes
No
Falsified information will lead to automatic rejection of the application, PAWS reserves the right to refuse any applicant
I understand it is my responsibility to see and evaluate the cat for myself before agreeing to adoption. The adoption of a lifelong animal friend should not be impulsive, but rather a carefully thought out decision, which will ensure a loving, lasting relationship.
Applicant signature:
Date:
-
Month
-
Day
Year
Date
Thank you for completing this questionnaire. This information will help us match you with the right cat for your family!
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