First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone*

Why are you interested in adopting a cat at this time?*

Please list family pets, along with how long you owned the pet, and where the pet is now.*

If you currently have pets, are they spayed or neutered?

Are your pets up to date on their vaccinations and monthly preventatives?

For cats only: Are you planning to declaw*
Choose one: Yes No

Please provide the name and phone number for your most recent, current or intended veterinarian.*

Do you have a contingency plan to pay for unexpected emergency vet bills?*

If you have a cat is he/she permitted to run loose?

If you have a dog, is he/she permitted to run loose?

What precautions will you take to introduce your cat into your home if you have other animals (a dog, cat, bird, rabbit, etc)? *

How soon do you want to adopt?*

Which cat or cats are you interested in?*
Choose an animal: Cindy Joey Lenora Lucky Monica Rachel Ross Sasha Tanner

Are you interested in a male or female cat?

Describe your ideal cat (age, long/short hair, color, personality, etc.)

In what type of home do you live?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home?*
Choose one: Rent Own

If you rent, does your landlord allow pets?

If you rent, have you received the approval of your landlord to have an animal?*
Choose one: Yes No Not Applicable

If you rent, please enter your landlord's name and phone number (if not applicable please type N/A in box).*

Please list the members of your household. Name/Relation/Age*

Are all the members of your household in agreement about adopting a cat?

Does anyone in the household have pet allergies?*

Who in the household will care for the pet?*

Will anyone be home during the day?

On a regular day, how many hours will the cat be left alone?*

Where will the animal be kept when you are not home?*

If you are adopting with a partner, who will get custody if there is a break up? *

Have you been involved in domestic disturbances in which the police were called? If so, explain.*

Have you ever had to give up a pet? If so, why and where did the pet go?*

Are you familiar with your local animal control laws?

If you are applying from greater than 30 miles away, what is your plan for meeting and/or obtaining the animal? (If you are local please put N/A in box)*

Do you agree to permit a visit to your home by appointment?

Have you applied to adopt with any other rescue?*
Choose one: Yes No

How did you hear about us?*

I certify that the information entered on this applicant is true. Please enter your name and date of application. *

Are you willing to sign legal pet adoption papers?

List 3 personal references below. (Include name and phone number) *