Applicant must be at least 21 years old.
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1. Today's Date:
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2. Desired Cat:
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3. Your Name (First AND last name):
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4. Your Occupation:
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5. Address:
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6. City
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7. Zip Code:
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8. Home Phone:
9. Cell Phone:
10. Work Phone:
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11. Email:
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12. What age bracket do you fit in?
Under 21 years old
21-25 years old
26-30 years old
31-35 years old
36-40 years old
41-45 years old
46-50 years old
51-55 years old
56-60 years old
61-65 years old
66-70 years old
71-75 years old
76-80 years old
81-85 years old
Over 85 years old
13. Name of Spouse/Partner at residence:
14. Spouse/Partner Occupation:
15. Other adults (21 or older) at residence. Please list name, age and relationship to you.
16. Name & age of children (21 years or younger) at residence.
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17. Is anyone at your house allergic to cats?
Yes
No
I don't know
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18. Own or rent?
Own
Rent
19. If renting, landlord's name & phone number:
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20. Which of the following pets do you currently have?
Dog(s)
Cat(s)
Rabbit(s)
Bird(s)
Reptile(s)
Fish
Rodent(s)
Do not have any pets
21. Please describe current pets, including breed, age, gender, length of time in your care
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22. Have you ever had an un-neutered/un-spayed pet?
Yes
No
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23. Have you ever lost a pet?
Yes
No
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24. Have you ever allowed a pet to breed?
Yes
No
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25. Have you ever given a pet away?
Yes
No
26. If you answered yes to any of the past 4 questions please explain:
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27. All pets you've owned as an adult; include deceased and those that were given away or lost. Provide details- length of time owned, what happened to them, what age they died, etc.
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28. What cat are you interested in and why OR describe what you are looking for (age, size, gender, breed, etc.)
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29. Why are you interested in adopting from a rescue?
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30. Would you declaw your new cat?
Yes
No
Maybe
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31. What are your primary reasons for adoptiong a cat?
Companion for You
Companion for Children
Companion for Current Pet
Gift
Other
32. If other, please explain:
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33. Do you have a veterinarian?
Yes
No
34. If yes, name and phone number:
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35. What brand of food will you use?
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36. How would you feed?
One scheduled meal a day
Two scheduled meals a day
Free feed (leave food out)
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37. Who would care for your cat when you go away?
Kennel
Hired pet-sitter will stay at my house
Friend/relative will stay at my house
Cat will stay at friend/relative house
Someone will stop in to feed/walk the cat
Other
38. If other, please explain:
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39. When will your cat be allowed outside?
Whenever he/she wants
Occasionally allowed outside
Always- cat will live outside
Never allowed outside
Other
40. If other, please explain:
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41. How many total hours per day would the cat be left alone? Please consider and include commute time, work hours and after work activities. How many days a week will the cat be home alone for these hours? Please provide as much detail about your schedule as possible.
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Indicates Response Required