Number of children in home? *

The children's ages *

How long have you lived at this address? *

Which best describes your current home? House
Condo
Apartment
Mobile Home
*

Do you rent, own or live with your parents? Rent
Own
Live with Parents
*

Please provide the name and phone number of your landlord (renters). *

If Apartment, on which floor do you live?

Please list all of the members of our household members (Names, Age, Relationship)? *

Does your home have a yard? Yes
No
*

Is your yard fenced? Yes
No
*

do you have a gate? Yes
No
*

Is the fence secured underground? Yes
No
*

Is everyone in your household in agreement on adopting a pet? Yes
No
*

Where will your cat spend most of its time? Inside
Outside
*

What provisions will be made for your pet when no one is home during the day? *

What provisions will be made for your pet when no one is home during the evening? *

What provisions will be made for your pet when you go on vacation? *

Do you want to adopt a male or female cat? Male
Female
*

Do you have an age range for your cat? *

How much time would you consider reasonable for your at to become accustomed to his/her new home? *

Are you willing to care for this animal for the rest of his/her life? *

What are your thoughts about declawing? *

Would you consider declawing your new cat and if so what would be the reason? *

Do you understand it will take a while for this cat to adjust in its new environment? Yes
No
*

Do you have a quite place for your new cat to adjust to its environment? if so where? *

Do you realize that children and cats need to be taught proper behavior toward each other? *

Your cat must be spayed/neutered between five and six months of age? Yes
No
*

Do you understand that we have the right to reclaim the unspayed female and her kittens if they were allowed to have a litter? *

If you do not spayed/neutered we can reclaim the cat do you understand? Yes
No
*

Do you understand that if any time you cannot or do not wish to keep this cat, that you MUST contact us in order to reclaim cat or assist with the rehoming? *

Under what cicumstances would you give up your cat? *

Do you have pet(s) currently? Yes
No
*

List your pets breed, age, and sex

Have any of your pets ever been lost or injured? Yes
No
*

If, Yes please explain

Veterinarian's Name and Phone Number *

Please also tell us what name the pet is under at the vet's office

Are your pets current on vaccinations?

are your current pets spayed/neutered?

Are your pets on Heartworm preventative?

When did you visit your veterinarian last?

Reference 1 (name, relationship, phone number, email address) *

Reference 2 (name, relationship, phone number, email address)

We ask a non-refundable adoption fee for a cat to help cover some of our care and vetting costs of spay/neuter, shots, meds, microchip, transport, food, etc. Please let us know if you are in agreement with this. ( Please mark yes or no in the check box below).

Please read: I certify that the information I have provided on this form is true, correct, and accurate. I am financially and physically able to care for the animal that I adopt.  I understand and agree that falsification of any of the above information is grounds to disqualify my adoption application and nullify all adoption(s) and/or adoption agreement. I understand that there is no obligation to adopt an animal to me, now or in the future.  I understand that my electronically-generated signature [below] is valid as a means of legal signature for the purpose of this adoption application.

Do you agree to pay the adoption fee for your new cat? Yes
No
*

Signature *

Date *