First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

If any required questions do not apply to your situation, please enter "N/A" as the answer.

Which cat or kitten are you interested in*
Choose an animal: Armadillo aka Armie Bobby Brock Bryce Buck Destiny Eleanore Roo Skip Wishlist - Dog

Employer/Occupation: *

Year of Birth. *

If under 21, please list the name and phone number of the person (over 21) that is agreeing to co-apply with you.

Please list the name of others living in home and their relationship to you. *

Are all of the members of your household agreeable to adopting a pet?*

What are the ages of the children or grandchildren that will be exposed to your pet*

Do you or anyone in your family have known allergies to any type of pet? If yes, please explain.*

Why are you interested in adopting a pet at this time*

How many continuous hours per day will your pet spend alone without human company?*

Where will your pet be kept when you are not home?*

PLEASE TELL US ABOUT YOUR CURRENT AND/OR PREVIOUS PETS (PAST 10 YRS).

Pet #1: Name - Breed - Age - What Happened to Pet*

Pet #2: Name - Breed - Age - What Happened to Pet

Pet #3: Name - Breed - Age - What Happened to Pet

Pet #4: Name - Breed - Age - What Happened to Pet

Additional Pets: Name - Breed - Age - What Happened to Pet

Were/are all of your pets spayed/neutered? If not, please explain.*

Do your current pets stay outside or inside?*
Choose one: inside outside (more than 4 hours a day) doggy door N/A ( no current pets)

PLEASE TELL US ABOUT THE HOME WHERE YOU NEW KITTEN/CAT WILL LIVE

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

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

If you rent, have you received the approval of your landlord to have a pet and are you aware of restrictions or pet fees? (Check all that apply.)

Please provide Name and Number of Landlord. *REQUIRED IF YOU RENT*

CAT HEALTH
The answers to the next few questions assist us in helping new or current owners keep their pets safe, and are not used to determine approval of application.

1) How do cats get heartworms? 2) Do cats that stay inside need preventative? 3) Once cats get heartworms, can they be treated?*

What is the name and phone number of the veterinarian(s) that has cared for your current or past pet(s)?*

Which vet do you plan to use if you are a first-time pet owner?

If you currently own a cat, has he/she been tested for Feline AIDS and Feline Leukemia? Do your current cats stay inside or outside? (Check all that apply)

PLEASE TELL US WHAT YOU ARE LOOKING FOR IN A PET

What traits are you looking for in a pet

Please explain the daily pet routine that you currently have or plan to have.*

TRAINING
If you have questions about training, please note below, and we will provide resources / discuss with you.

Cats have been known to claw furniture, carpet and drapes, dig in potted plants, etc. How do you plan to deal with these potential problems?*

Are you aware that declawing is: 1) considered a major surgery that requires pain management, and 2) should only be considered only after all other alternatives have been exhausted (appropriate scratching surfaces, nail caps, training, etc).*

Are you aware that cats can be trained, similar to dogs?*

OWNERSHIP RESPONSIBILITIES

What arrangements will you make for pet in the case of emergency or evacuation?*

What plans do you have for your pet if you should become unexpectedly ill and/or can no longer care for pet? (Is another family member or friend agreeable to assuming care for your pet?). Please explain.*

Are you aware that some pets can live 15-18 yrs and beyond, and do you agree to commit to a pet for the his/her lifetime?*

Please list any other information or comments you would like us to take into consideration when reviewing your application and considering your adoption request.

Please let us know the best time(s) to contact you and at which number(s).

Please let help us to serve our rescued pets better by letting us know how you heard about us. If found us through the internet, please let us know through which website you were linked to us (Petfinder, Pets911, Adopt-A-Dog, etc.)

By signing below, I certify that the information entered on this application is true and that knowingly falsifying information will result in the denial of said application. I also understand and agree that submitting this application places me under no obligation to adopt any animal from Pet Adoption Services, Inc, nor is Pet Adoption Services, Inc obligated to approve my application or adopt any animal to me, and that the applicant(s) and/or Pet Adoption Services, Inc may discontinue or withdraw from the application process at any time.
I give my veterinarian permission to release any and all health records of my current and past pets.  
I agree that my landlord be contacted to confirm pet policy and residence.
I agree that entering my name and date will serve as my signature.

Signature*

Date*