| 1. |
1. How long
have you lived at this address?
years
months |
| 2. |
Do you rent
your home or live in a trailer park?
Yes
No
If yes, we need to confirm that you are allowed to own a pet.
Please complete the following information in full.
Landlord's Name
Landlord's Phone
Landlord's Address
|
| 3. |
Are you a college
student?
Yes
No
Do you live on campus?
Yes
No
If yes, whom should we contact to confirm that you are allowed
to keep a cat?
Contact's Name
Contact's Phone
Contact's Address
|
| 4. |
Do you have
young children living with you?
Yes
No
If so, how old are they?
|
| 5. |
Are you presently
employed?
Yes
No
Retired |
| 6. |
Is your partner
presently employed?
Yes
No
Retired |
| 7. |
Have you adopted
a pet from a rescue group or shelter
before?
Yes
No
If so, how many?
|
| 8. |
Have
you ever surrendered any pet(s) to a rescue group
or shelter?
Yes
No - If so, why?
|
| 9. |
Do you have
any pets at this time?
Yes
No
If so, how many?
Please list their names and what kind of pet
|
| 10. |
Do you keep
your pet(s) up-to-date on vaccines, as recommended by your veterinarian?
Yes
No
Not Applicable |
| 11. |
Are your pets
spayed or neutered?
Yes
No |
| 12. |
Do you give
your permission for us to confirm your answers to questions 10
and 11?
Yes
No
Not Applicable
If yes, your vet's name is?
Practice Name
Phone
|
| 13. |
Will
your cat be:
Indoor only cat
Indoor/outdoor cat
Outdoor only cat
|
| 14. |
Are you familiar
with the law requiring all cats be kept up-to-date with their
rabies vaccination?
Yes
No |
| 15. |
Do you understand
what vaccinations and other health care your new cat will require
each year?
Yes
No |
| 16. |
Do you agree
to take your pet to a veterinarian every 12 months to receive
an annual check up and booster shots?
Yes
No |
| 17. |
Do you agree
to take your pet to a veterinarian as soon as possible if he/she
is sick or injured?
Yes
No |
| 18. |
Are you familiar
with flea prevention preparations that are available for cats?
Yes
No
If not, would you like to receive information?
Yes
No |
| 19. |
If you have
other pets in your household, do you appreciate that it may take
time for your new cat to accept, and be accepted by, other pets
in your household?
Yes
No |
| 20. |
Do you agree
to kiss your new cat on the nose at least once a day?
Yes
No |
|
I certify that the facts in this application are true and complete;
and understand that falsified statements on this application shall
terminate the adoption process. |
|
|