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By
CatsInc
on December 26, 2014
About the Cat
Name of Cat
Cat ID (if known)
Description & Color of Cat
*
Gender:
Female
Male
About You
First Name
*
Last Name
*
Email Address
*
Primary Phone
*
Secondary Phone
Full Street Address
*
City
*
Age
*
0
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
Option 83
Option 84
Option 85
Option 85
Other
Age
State
*
California
————–
Alabama
Alaska
Arizona
Arkansas
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
Zip Code
*
Occupation
*
Spouse/Partner Name or N/A
*
Spouse/Partner Occupation or N/A
*
Who will be responsible for daily care of this cat?
*
Why do you want a cat?
*
Companion for me
Companion for another pet
Child wants a pet
Mouser
Gift for another
Other
If other, please explain:
Number of Persons in Household
*
1
2
3
4
5
6
7
8
9
10
More than 10
Anyone in household allergic to cats? If so, who?
*
Number of Children under 16:
*
0
1
2
3
4
5
6
7
8
9
10
More than 10
Ages of children in household or N/A:
*
If you have children, have they been around cats before?
*
Yes
No
List other pets currently in household – Type, Breed, Age, Name
*
Name & City of Vet:
*
Residence Info
Type of Residence
*
House
Townhouse
Apartment
Mobile Home
Other
Rent or Own?
*
Rent
Own
Landlord’s Name & Phone Number
Length of time at current address?
*
Under 6 months
6-11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
Over 7 years
This cat will be:
*
– Please Select –
Indoors Only
Mostly Indoors
Outdoor Days, Indoor Nights
Mostly Outdoors
Outdoors Only
This cat will have access to:
*
Balcony
Patio
Garage
Yard
None of the Above
Do you have:
*
Leather Furniture
Wicker/Rattan Furniture
Household Plants
Fishtank(s)
Bird Cage(s)
Recliner or Rocking Chair
Washer/Dryer
None of the Above
Location of cat’s litter box?
*
Do you have a dog/cat door?
*
No
Yes
Where will the cat sleep at night?
*
What will happen to your cat when you’re on vacation or out of town?
*
Can you afford regular veterinary care–including annual physical exams, vaccinations, dental care, etc? ($100 or more per year)?
*
No
Yes
Can you afford serious injury or illness costs ($500+)?
*
No
Yes
For what reason(s) would you give up the cat?
*
Allergy
New baby
Moving
Illness
Divorce/Separation
Unemployment
Not getting along with other pets
Scratching furniture
Peeing on carpet/furniture
Scratching children
None
Other
If other, please explain:
What would you do if…
Who would take the cat if your relationship changed?
*
had to move & had trouble finding a place that allowed pets?
*
the cat stopped using the litter box?
*
the cat clawed your furniture?
*
the cat kept trying to get outside?
*
if you had to relocate out of state or overseas?
*
Are you satisfied that a volunteer could help you if these issues occur?
*
Yes
No or Not Sure
May we contact you in the future to check on your new cat?
*
Yes
No
If no, why not?
Have you ever owned cats before?
*
Yes
No
If yes, what happened to them?
Have you ever owned kittens before?
*
Yes
No
If yes, what happened to them?
Have you ever owned a declawed cat?
*
Yes
No
Will you declaw this cat?
*
Yes
No
If you had a previous pet put to sleep, what source did you use?
*
Vet
Shelter
What were the circumstances?
Have you ever bred a cat or dog?
*
Yes
No
If yes, what type was it?
Did you breed for:
Show
Fun
Profit
Accident
Miracle of Birth
PLEASE READ CAREFULLY: You are making a major commitment when you adopt any pet. Please remember that CATS CAN LIVE FOR OVER 20 YEARS. Thousands of cats are killed at animal shelters each year because their owners did not plan for the future. Cats can get sick & require expensive medical treatment during the course of their lives. Cats need affection, attention & understanding. You may have to adjust your lifestyle to accommodate a new pet. CHECK HERE IF YOU ARE READY TO MAKE THIS COMMITMENT.
*
I Agree
If you are human, leave this field blank.
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