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CAT ADOPTION APPLICATION
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Name
*
First
Last
Phone
*
Email
*
Physical Address
*
Address Line 1
Address Line 2
City
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California
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Connecticut
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State
Zip Code
Do you have a different mailing address?
Yes
Mailing Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Occupation
*
Where will the cat live with you? (check all that apply)
*
House
Apartment
Duplex
Mobile Home Park
Live w/ Parents
Other
Please explain:
Do you ______ your home?
*
Rent
Own
Other
Please explain:
Do you have a written lease or agreement allowing pets?
*
Yes
No
Are there any restrictions on type, species, size or breed of pets you may have?
*
Please provide your landlord's name and contact information:
*
List any individuals that will be living in the household with the pet. Please include age and relationship to each person listed:
*
List any pets currently living in the household. Include the gender of the animal, the age of the animal and if they are currently spayed or neutered:
*
Are you aware the yearly vaccinations and routine preventative vet care typically costs between $80 - $200 per year?
*
Yes
No
Who is your Veterinarian?
*
How will you transport your pet home, to the vet, etc?
*
Have you ever been convicted of a crime that involved an animal(s)?
*
Yes
No
Have you ever had a pet euthanized?
*
Yes
No
Please explain:
Have you ever turned your dog or cat into a shelter?
*
Yes
No
Please Explain:
Please indicate the reason for adopting your pet: (check all that apply)
*
Companion
Family pet
Child's pet
Companion for other pet
Gift
Other
Please explain:
Does your home have a yard?
*
Yes
No
Other
Please explain:
Typical time away from home during the work week:
*
Home all day
1 - 3 Hours
4 - 6 Hours
7+ Hours
Other
Please Explain:
If you are gone during the day, is someone else home?
*
Yes
No
Is that person willing and able to be responsible for looking after the cat?
Yes
No
Maybe
Where will your pet be kept during the day?
*
Indoors only
Outdoors only
In and out
Other
Please Explain:
Where will your pet be kept during the night?
*
Indoors only
Outdoors only
In and out
Other
Please Explain:
Would you object to an authorized representative of the SHS inspecting the animal and the premises where the animal is kept?
*
Yes
No
Would you like to join our mailing list?
*
Yes
No
How did you hear about us?
*
Facebook
Radio
TV
Friend
Newspaper
Supersaver
Adopted here before
Other
Please explain:
By typing my full name below, I am certifying that all the above information is true and accurate. I also understand that a giving false information on this application is grounds for denying my application.
*
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