Cat Application Form

Applicant Information

Name*:

Address*:

City*:

State*:

Zip*:

 

Age*:

Driver's License*:

Home Phone:

Cell Phone:

Work Phone:

Email Address*:

Currently enrolled in college? YesNo

 

Current Employer*:

Full/Part Time: Full TimePart Time

If unemployed, what is your source of income?

Which cat/kitten are you interested in adopting?*

Who will be the primary caretaker of the new pet?*

Current Pet Information

First Pet's Name:

Breed:

Age:

Male or Female? MaleFemale

Spayed/Neutered? YesNo

Indoor/Outdoor? IndoorOutdoor

 

Second Pet's Name:

Breed:

Age:

Male or Female? MaleFemale

Spayed/Neutered? YesNo

Indoor/Outdoor? IndoorOutdoor

 

 

Third Pet's Name:

Breed:

Age:

Male or Female? MaleFemale

Spayed/Neutered? YesNo

Indoor/Outdoor? IndoorOutdoor

 

What other pets do you currently own?

Other pets currently living in the home that you don't own

 

Veterinarian's Name*:

Veterinarian's Phone*:

Who's name are the records under?

Please call your veterinarian and give permission to release your records to the Lawrence County Humane Society.

 

Are you looking for an indoor or outdoor cat? IndoorOutdoor

Where will the cat/kitten be kept when no one is home?*

How many adults live in the household?*

How many children live in the household?*

Children's ages?

Have you ever adopted an animal from an animal shelter before? YesNo

If yes, from where and how long ago?

Have you ever returned an animal to a shelter/rescue? YesNo

If yes, please explain:

Are you in favor of spaying/neutering your pet? YesNo

Are you in favor of declawing a cat? YesNo

Are you aware that the new animal you may adopt has not been examined by a veterinarian while housed at our shelter? YesNo

Housing Information

Do you own or rent? OwnRent

How long have you lived at current residence?

Type of home: Single FamilyCondoTownhouseTrailer

Name of mobile home park, apartment complex, or condo complex:

Name of landlord/property manager:

Phone number of landlord/property manager:

 

What is your main reason for wanting to adopt the animal you are applying for today?

 

Signature: