Application Form

Cat you are interested in adopting: 
About you:
Your Name:     Address:    Age: 
City:  State:   Occupation: 
Home Phone:    Cell Phone:   E-mail: 
How long have you lived at your current address:    Years.
  I am a:    Applicant and my source of income is: 
I am    My home is a   and I    my home
Does your landlord allow pets? 
(Before adoption we need a document from your landlord stating you have permission to have a cat.)
Please give the name, address, and phone number of your landlord for verification purposes: 
How many pets currently in your household?
What vet do you use for these pets? Vet name, address and phone number:
Personal reference name:
phone number:
Please give the following information about pets currently living in your home:
Pet 1 – Name:  Type:  Sex:  Breed: 
Age:  Fixed:  Resides: 
Pet 2 – Name:  Type:  Sex:  Breed: 
Age:  Fixed:  Resides: 
Pet 3 – Name:  Type:  Sex:  Breed: 
Age:  Fixed:  Resides: 
Pet 4 – Name:  Type:  Sex:  Breed: 
Age:  Fixed:  Resides: 
Are your pets up to date on rabies and booster shots, yearly exams etc  
If not, why not:
If you have more than 4 other pets, describe briefly:
list any vets you have used in the past.(Name, location, and number if available):
Which vet would you be using for this cat – Vet address and phone number:
Would the vets listed here have records for all the pets listed? 
Is it ok if we call the vet(s) for verification of the pet records? 
How many people are living in your household?  
Please give the ages and sexes of any children: 
Do all of the adults in the household share in the decision to adopt? 
Are all of the adults of the household present today? 
Are you planning on giving this cat as a gift? 
If a gift, will the cat continue to live in your current home, or will it be living elsewhere? Please explain:
Who will have primary responsibility for the cat?
What best describes your lifestyle?
Where do you plan to keep this cat ?
Do you plan on declawing this cat?
If so, why?:
What methods of training would you use to deter unwanted behavior?
Does anyone living in your household have any known allergies to cats? 
If yes, please describe how you would handle that:
Have you ever adopted from this or another rescue group/shelter? 
If yes, please give the name and location of the rescue group:
If you have other pets, how will you introduce the new cat?:
Is there a secluded area of your home where the new cat can become adjusted? 
If you are getting this cat “for the kids” have you considered when the kids grow up, leave home, develop other interests etc. Will you still want the cat? 
What might you do if you had to move somewhere that did not allow pets?
How much do you think you would spend monthly on vet care, feeding, grooming etc:
How long have you been considering adopting a cat?
I hearby certify that the statements I have made in this application are true and complete. I understand that false or misleading statements can terminate the adoption process.
I understand this is just an application, NOT a contract, and there is no implied promise that this cat will be mine just by completing this form.
Signed: Dated: