adoption forms

Are you interested in adopting a cat or dog? *

Cat Dog

Date *

Full Name *

First Name Last Name Suffix

PA Driver's License # *

Home Phone Number *

Area Code Phone Number

Are you over 18? *

Yes No

Address *

Street Address

Street Address Line 2

City State

Zip Code

E-mail Address *

Are you adopting for yourself or someone else? *

Self Someone else

Do you own or rent your residence? *

Own Rent

If you rent, please provide the name and phone number of your landlord (enter n/a if not applicable) *

How many people reside in your household? *

Does anyone have allergies to pets? *

Yes No

If there are children, what are their ages (enter n/a if not applicable)? *

Who will be responsible for the care of the cat/dog? *

Where will your cat/dog be kept? *

Inside Outside Both

Do you plan to declaw your cat? *

Yes No n/a - dog adoption

Who will be responsible while you are away? *

Have you owned a pet before? *

Yes No

Describe those pets and their current health (enter n/a if not applicable) *

Breed of cat/dog you're interested in (enter n/a if not applicable) *

Name of cat/dog you're interested in (enter n/a if not applicable) *

Vet reference and phone number (enter n/a if you do not have a pet) *

Please contact your veterinarian to authorize the release of reference information on your current pet(s) to The CatWorks.

Name of non-family member personal reference *

Phone Number of reference *

Area Code Phone Number

I understand that all of the above fields are mandatory. By submitting this form I represent that the information I have provided is the truth to the best of my knowledge and belief.

*Required