Applicants name?
Street Address
City State
Zip Code Phone number (work) Phone number (home) Your e-mail address?
Do you own or rent?
Own
Rent
Age Are you over 21?
Yes
No
Do you live in?
House
Apartment
Condo
Co-op
Trailer
Other
If you rent, do you have landlord's permission to have pets?
Yes No Landlords Name & Phone #
Do you have screens on the windows?
Yes No
Are the screens secure?
Yes No
Is anyone in the home allergic?
Yes No Will you agree to allow us to visit your home by appointment as part of our application process?
If no, explain why:
How many adults in your home?
Are there children in the home?
How many & Ages
Are they used to being around cats?
Yes No
Who will be responsible for pet care?
Do you have dogs now?
yes no
If yes, list breeds, age and sex:
Are all dogs spayed/neutered?
Yes No If no, please explain
Do your dogs have any physical problems?
Yes No If yes, please explain?
Do your dogs have behavioral problems?
Yes No If yes, please explain?
Do they get along with cats?
yes no If you no longer have your dogs what happened?
Do you have cats now?
yes no
If yes, list breeds, age and sex:
Are all cats spayed/neutered?
Yes No If no, please explain
Do your cats have any physical problems?
Yes No If yes, please explain?
Do your cats have behavioral problems?
Yes No If yes, please explain?
Do they get along with other cats?
yes no If you no longer have your cats what happened?
Have they been Leukemia and Feline Aids tested?
Do you have other pets?
Yes
No If yes, what kind and how many?
What Vet did/do you use (name, address, phone number please, must be verified)?
Pets name that you took to the above Vet?
Check all that apply: You are looking for a cat as a:
Playmate for current cat Companion for self Companion for family To fill the void of a beloved deceased cat
Check all that apply: What age group are you looking for?
Baby (8 to 12 weeks) Kitten (12 weeks to 1 year) Young adult (1 to 2 year) Adult (2 to 5 years) Older adult (5+ years) Senior (10+ years) Please explain your age preference
Would you consider taking a pair of cats?
Yes No
Male or female cat?
male female
Do you have a color or breed preference?
Who will be responsible for the care of your cat? (feeding etc)?
Would you declaw your cat?
Can you commit to this cat for it's entire life?Yes
No If no, explain?
Will this cat be indoor, outdoor or both?indoor only
outdoor both
Personal Reference # 1 (Name, Phone/Email)
Personal Reference # 2 (Name, Phone/Email)
Any other requirements or comments you'd like to share
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