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How long have you lived at this address? years months
Is your residence a House Apartment Condo Other
Do you Rent / Lease Own
If you lease or rent, does your agreement allow pets?
Yes No
Lessor Name
Lessor Phone
Do you plan on moving in the future? Yes No
If yes, what plans have you made to accomodate your pet ?
How many adults at this residence? How many children?
Does anyone in your home have allergies? Yes No
Do any other animals currently reside with you? Yes No
If yes, how many of each? Cat(s) Dog(s) Other
State the Breed, Age, & Description of each animal currently residing with you:
Do your pets have current vaccinations? Yes No
Veterinarian
Would you allow the cat:
Indoors Only Outdoors Only Indoors and
Outdoors
If allowed outdoors, please describe the circumstances:
Personal reference:
Name Phone
Do you have secure screens in your windows? Yes No
Do you anticipate de-clawing this cat? Yes No
Who will be the primary caretaker of the cat?
Who will care for the cat when you are away from home?
Have you ever taken one of your pets to a shelter? Yes No
If yes, explain
Have you ever had a pet euthanized? Yes No
If yes, explain
Have you ever lost a pet or had one die of accident or injury? Yes
No
If yes, explain
What are the most important issues to you in choosing a companion cat?
How did you find this adoption listing?
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