RCHS Application for Cat(s)

Ritchie County Humane Society Adoption Application - CAT
Name of Cat(s) You Wish to Adopt
Full Name *

First Name Last Name
Age
E-mail *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number - Home *

Area Code Phone Number
Phone Number - Cellular

Area Code Phone Number
Place of Employment *
Phone Number - Work

Area Code Phone Number
Do you live in a: *
Do you: *

Own Rent Live with Parents Other
If Renting: Please indicate landlord contact information
Household Setting

Rural City
How long have you lived at your current address? *
Describe the Activity Level in your Home *

Busy/Noisy Moderate Comings/Goings Quiet with Occasional Guests
Please List all People Living in the Household (Include Name, Relationship, Gender and Age) *
Does Anyone in your Household have Allergies to Animals?

Yes No
Are all members of your family agreeable to Adopting a Cat? *

Yes No
Please List any Pets you have Currently or Within the past 10 years (Please include Name, Breed, Age, Spayed/Neutered, Sex, Living/Deceased) *
Do we have permission to call your veterinarian for a reference check? (Please authorize vet to speak with us) *

Yes No
Veterinarian Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Where will your cat live? *

Strictly Indoors Indoor/Outdoor Strictly Outdoors
Do you plan to declaw this cat? *

Yes No
If you move, will you look for a home where you can take your cat with you? *

Yes No
Please help us determine where our marketing is working best. Where did you see this cat's listing?

PetFinder AdoptAPet RescueMe Facebook
Do you understand that we require this cat to be spayed/neuter within 30 days in accordance to WV law? *

Yes No
Do you agree to provide regular health care? *

Yes No
Do you agree to contact us if you can no longer keep the cat? *

Yes No
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval.

I certify that the above information is correct, and I understand that the information will be verified.
Click to edit

Month Day Year Hour Minutes AM/PM Option
Your name *
Co-Applicant name (if applicable)
Should be Empty:

Ritchie County Humane Society Adoption Application - CAT