First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone*

What is your age?*

What is your occupation?*

Name of Spouse or Partner, if applicable. If not married or partnered, please answer NA*

What is your spouse/partners occupation?*

How many hours per day are you away from home?*

If married, how many hours is your spouse gone per day?*

How many children are in the home?*

What are ages of children in the home?*

I live with

How many ADULTS reside in your home? *

Please list ages of all adults living in the home*

Who will care for pet?*

Does anyone in your home have allergies? If yes, please indicate what they are allergic to.*

If you or a family member/roommate have allergies, how do you/they cope with them?*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

How long have you lived at this address?*

Where will you keep your cat when it is left alone?*

Where will your cat stay?

If your cat will be allowed outside, how long after adoption would you start allowing the cat to go out?*

Where will your cat spend the night?*

Do you have any of the following?

Will your cat have access to doggy door or cat door?*

In what areas will your cat be allowed in?*

Is this your first pet?*

What pets have you owned in the past and for how long? What happened to them?*

What other pets do you currently have in your home? Please list species, age, gender (spayed or neutered?) and weight/size*

Have you ever given up a pet? If yes, please explain*

Would you consider declawing your cat?

Cats live long lives. Are you prepared to care for this pet for 15 to 20 years?*

Name and phone number of veterinarian*

What would be the most you would be willing to spend at the vet for a sick or injured pet?*

How do you/would you handle the situation if your cat pottied outside of the litterbox?*

What type of cat behavior do you consider unacceptable?*