Cat Adoption Form Step 1 of 4 - Applicant Info 25% Date MM slash DD slash YYYY Applicant Name First Last License # Co-applicant Name First Last License # Address Street Address City State / Province / Region ZIP / Postal Code (PO box unacceptable) Applicant Email Home PhoneCellWorkApplicant Age Co-applicant Email Co-applicant HomeCellWorkCo-applicant Age Living Situation House Apartment Condo Mobile Home Do you own or rent your home? Own Rent If you rent, please provide copy of lease agreement and/or pet rider and complete the following line:Landlord or property manager’s name and phone number: How long have you lived at this address? Will this be your first cat? Yes No What kind of pets have you had in the past?Which of these do you still have? (Include name, age, sex and breed.)Have they been spayed or neutered? Yes No Don't Know Are they current on vaccinations? Yes No Don't Know Have your cats been tested for feline leukemia? Yes No Don't Know Have your cats been tested for FIV? Yes No Don't Know Are your cats declawed? Yes No If yes, where is the cat declawed? Front paws All four paws Who is your veterinarian? Name of Practice PhoneCity/State What happened to the pets you no longer have?Have you ever surrendered any of your animals to a shelter? Yes No If yes, please explain:Have you ever had a pet euthanized? Yes No If yes, please explain:If you have pets, will they adjust to a new cat in the house? Yes No Don't Know Why do you want this cat? Companion Companion for other pet House pet Barn cat Mouser Office cat How many adults are in your family? How many children? Children’s ages? Does any member of your household have an allergy to cats? Yes No Is someone home during the day? Yes No If yes, who? How many hours each day will the cat be without human companionship? Please explain:(Please consider adopting 2 cats if there is no-one home all day)Where will you keep the cat? In the house Outdoors With free access both indoors and outdoors In the barn Please explain:Do you have a cat or dog door? Yes No Will you have the cat declawed? Yes No Maybe Are you aware of the potential side effects of this operation? Yes No Will you keep the cat up-to-date on vaccinations? Yes No If you go away for a few days, or on a vacation, who will take care of the cat? If you move, will you take the cat with you? Yes No Are you aware that cats can live 15 to 20 years and are you willing to take responsibility for this cat for the next 10 to 20 years? Yes No If no, explain:What provisions will you make for the cat should you become unable to care for him/her? Personal Reference 1 First Last Relationship Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Personal Reference 2 First Last Relationship Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail
