Name
*
First Name
Last Name
Email
*
Spouse/Partner/Roommate First Name:
Spouse/Partner/Roommate Last Name:
Address (Line 1):
Address (Line 2):
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email Address:
Are you over 21?
Yes
No
Occupation:
Work Hours:
Employer:
How long have you been with this employer?
Work Phone:
What age cat do you wish to adopt?
What gender cat do you prefer?
Color preference:
Claws:
Reason for claw preference?
Preferred Temperament?
What do you expect to spend annually on your cat's needs?
Can you realistically commit to caring for the cat you adopt for its entire life?
If yes, why?
If the cat became seriously ill and required costly veterinary care, what would you do?
How will your new cat/kitten spend its days and nights? Check all that apply.
If other, please explain:
If you move where pets are not allowed, what will you do with this cat/kitten?
Who will be primarily responsible for providing daily care?
It may take a cat/kitten a month or longer, especially when other pets are involved, to adjust to its new home. How would you address this?
What will you do in the event of scratching of your furniture?
Urinating outside the litterbox?
Aggressive behavior?
Why do you want a cat?
Is there a specific cat or kitten you are interested in?
If yes, Name & Description:
Why are you interested in this specific animal?
How many adults live in your home?
How many children live in your home?
What are the children's ages?
Have your children lived with cats previously?
Was it successful?
Do you live in an...
Do you own or rent?
If you rent, do you have written permission from your landlord to have a cat?
Landlord Name:
Landlord Phone:
Any community restrictions/ordinances on cats?
What is you or your family's lifestyle currently like?
How many dogs do you currently have?
Ages:
Breeds/mixes:
If an inside dog, how many hours is your dog crated or kenneled when you are not home?
Has your dog been exposed to or lived with a cat previously?
Was it successful?
If you do not have dogs currently, how many dogs have you had in the last ten years?
What happened to them?
Where did you obtain the dogs from?
Is your dog neutered and current on its annual innoculations for Distemper, Rabies, and Bordetella?
If no, why?
How many cats do you have?
Ages:
If you do not currently live with cats, have you owned any cats in the past ten years?
What happened to them?
Are your cats declawed?
Does your cat(s) always live:
Any behavior issues?
Physical problems?
Does your cat get along with other cats?
How many hours is your cat left alone each day?
Where did you obtain your cats from?
Is your cat current on its annual inoculations for Distemper and Rabies?
If no, why?
Please list any other pets you currently have:
Veterinarian's Name:
Veterinarian's Phone:
Clinic Name:
City:
State:
