First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
x

Cell Phone*

Text/Pager Email

Which animal are you interested in?*
Choose an animal: Amber Blanca Hippy Larry Nicky Pixie Rowan Tabith tigTiggerger Tori vanna

Your age and occupation?*

Spouse or partner name, age and occupation?

Are there children in the home?*
Choose one: Yes No

Please tell us the names and ages of all others living in the home (children, other adults, etc.)

Is anyone in the household allergic to cats/dogs?*

What type of dwelling do you live in?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing Farm Patio Home Other

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

If you rent, please enter your landlord's name and phone number*

If you rent, have you received the approval of your landlord to have an animal*
Choose one: Yes No

If you rent, is there a pet deposit and have you already paid it?*

Tell us about your current pets. Include the name, species, breed, age, time owned and if they are spay/neutered.

Are your current cats indoor, outdoor, or indoor/outdoor?*
Choose one: Inside only Outside only Inside and Outside Don't currently have a cat

Are any of your current cats declawed?

Are all your pets current on their vaccinations?

Are your current cats tested for FIV/FeLV?

Tell us about your past pet experience. Please include name, species, breed, age, time owned, if they were spay/neutered, and what happened to them: did they pass away? Get lost? Given away? Etc.*

Have you ever given up a pet? If yes, please explain*

Your Veterinarian's Name and Phone Number*

What traits are you looking for in a pet

Would you prefer to adopt an indoor-only cat or an outdoor-access cat?
Choose all that apply: Inside Only Outside Only Inside and Outside

Why are you interested in adopting a pet at this time*

For whom are you adopting this pet*

Who will be responsible for care of this pet if you are on vacation or move unexpectedly?*

What will happen to this pet if you move unexpectedly*

Where will this pet sleep*

What food do you plan on feeding your pet?*

Where will your cat’s litter box be kept*

Have you ever had an animal with severe medical problems*

If your new cat develops severe medical problems, how would you handle it*

Do you plan on having more children in the future? (Some cats adapt well to children, some do not.)*

What type of behaviors do you find inappropriate in a cat*

Are there some areas of the house that are cat-free zones*
Choose one: Yes No

Will your cat be allowed on the furniture*
Choose one: Yes No

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

What circumstances might prompt you to declaw your cat*

Financial concerns: We strongly recommend a yearly checkup for most cats; twice a year for cats with medical issues. In addition to the checkup, vaccinations may be appropriate, as well as treatment for illness or injury. How much are you prepared to spend annually on medical costs for your cat?*

I certify that the information entered on this applicant is true. Enter your name and date*

List at least one reference with a phone number (who is not a family member)*

How did you hear about us?*

Do you have any comments or questions for us