Caly's Cats Adoption Application

Contact

Name:
First:black line Last:black line
Address:  black line
  black line
City: black line
State: black line
Zip: black line
Home phone: black line
Work phone: black line
Cell phone: black line
Email: black line
Employer? black line Occupation? black line How much travel? black line
Please provide two personal references:
1. Name: black line Phone: black line
2. Name: black line Phone: black line

Cats

Kitten/Cat Name: black line Description: black line
1. What type of cat are you interested in?
Male
Female
Adult
Kitten (under 5 months)
Senior (9+ years)
Long Hair
Medium Hair
Short Hair
Color: black line
Personality characteristics you would like (check all that apply):
Shy
Talkative
Quiet
Affectionate
Friendly to people
Friendly to cats
Aloof
Independent
Likes to sit on laps
Likes being held
Wants to be left alone
Wants to be in charge
Mischievous
Relaxed
Very active
Playful
Easy going
Nervous
Sleeps a lot
Plays rough
Any characteristics you'd prefer not to have? black line

New Home

2.Do you own or rent your residence?
Own
Rent
Landlord's name: black line Landlord's phone: black line
Are companion animals allowed?
Yes
No
Don't Know
3.Where do you live?
House
Townhouse
Condominium
Apartment
Moblie home
Farm
4. How far from the road/traffic is your home located? black line
5.How heavy is the traffic on this street?
Light
Medium
Heavy
6. How many adults in your household? black line
7. How many children in your household? black line
List ages: black line
8.Does anyone in your household have any allergies to animals?
Yes
No
If Yes, please explain:
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9.How active is your household?
Very active
Somewhat active
Somewhat quiet
Very quiet
10.If you have a dog, where does he/she spend his/her time?
Mostly inside
Mostly outside
When outside, how is he/she confined?  black line

Cat Care

11.For whom are you adopting the cat(s)?
Self
Gift
12. Who will be be responsible for the cat(s)'s care? black line
13.Where will the cat(s) be kept?
Indoors only
Outdoors only
Both in & out
When outdoors will the cat(s) be
attended
unattended
and have collar & tags
Yes
No
14.Will anyone be home during the day?
Yes
No
15. How many hours will the cat(s) be left unattended (in or out)? black line
16. When no one is home, where will the cat(s) be kept? black line
17.Are your companion animals current on their vaccinations?
Yes
No
18. Please provide the name of your veterinarian: black line
Phone: black line
Please contact your veterinarian to allow release of your records to Caly's Cats.
19. How do you plan to introduce the cat(s) into your home if you have other animals?
 
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20. What will you do if the cat(s) does not get along with your present companion animals?
 
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21. If a disciplinary or behavior problem arises, how will you respond to it?,
 
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22. What will you do if the cat(s) start scratching the furniture?
 
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23. What will you do with the cat(s) if you have to move? black line

Experience

24.Have you ever had a companion animal before?
Yes
No
25.Have you ever adopted an animal from a rescue/animal control agency?
Yes
No
26.Have you ever had an adoption application rejected by a rescue/animal control agency?
Yes
No
If so, what were the circumstances?
black line
27. Describe those companion animals you still care for or that are living in your household:
Name Type Breed Age Sex Spayed/
Neutered		 Where kept during the day Where does he/she sleep How long owned
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
28. Describe those companion animals you no longer care for:
Name Type Breed Age Sex Spayed/
Neutered		 Where kept during the day Where did he/she sleep How long owned
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
black line black line black line black line
 
 M
 
 F
 
 Spayed
 
 Neutered
 
 Unaltered
black line black line black line
29.Have you ever had to relinquish an animal you had?
Yes
No
If yes, what were the circumstances?
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Responsibilities

30. Why do you want to adopt the cat(s)? black line
31. What do you think the annual cost of care for a cat is? $ black line
32. How much do you think a large vet bill is? $ black line
33. Are you financially able and willing to provide annual checkups, vaccinations,
and any medical care necessary?
Yes
No
34.Are you familiar with your local animal control laws?
Yes
No
35.Will you permit a cat-safety inspection of your home by appointment?
Yes
No
36.Are you willing to sign legal adoption papers?
Yes
No

Signature

 By checking this box I/we certify that all information on this form is true and correct. I/we understand
that any misrepresentation of fact may result in Caly's Cats refusing adoption privileges
on me/us. If my/our request for adoption is approved and later Caly's Cats discovers the
above information is not true or correct, Caly's Cats reserves the right to remove the
adopted cat from my home.
Signature: black line
Date: black line