Howard county cat club adoption application
NAME: _____________________________________ PHONE: _________ ADDRESS: ___________________________________________________
DRIVERS LICENSE______________________________________________________
1. Do you want the cat for yourself or is it a gift?
__ For me personally
__ Gift for other person
2. Are you a student?
__ Yes__ No
3. Do you own or rent your home?
__ Own__ Rent
If you rent, will your landlord give you written permission to have a cat?
__ Yes__ No
4. Do you have children?
__Yes __________________________Ages
__No
5. Do you have a cat or dog now?
__ Yes__ No
If you have a dog, what breed is it?_______________________________
6. How long have you had your cat or dog?
__ 0-3 years__ 3-6 years__ 6+ years
7. If no, have you ever had a cat or dog?
__ Yes__ No
8. How long did you have the animal?
__ 0-3 years__ 3-6 years__ 6+ years
9. What happened to your cat or dog?
__ I gave it to another person.
__ I turned it in to a shelter.
__ It died of (disease)______________________ at (age) _________________
__ It ran away
__ It was hit by a car.
__ It was poisoned: Do you live in the same place now? ____yes _____no
10. Have you ever turned a cat or dog in to a shelter? ___ yes ___no
If you have, why did you give the animal up? _______________________________________________________________________
11. Who is (was) your veterinarian? ___________________________________________
12. Are your pets spayed/neutered?
__Yes __No
13. Do you plan on having the cat declawed?
__ Yes__ No
14. What do you plan to feed the cat?
__ dry food only __ dry & canned food __ dry with a bit of canned food as a “treat”
__ homemade food __ raw food
15. If you moved, what would you do with the cat?
__ Take it with me __ Find a new home __ Take the cat to a shelter or rescue __ Other (explain)
16. What will you do with the cat when you’re on vacation?
___ Take it with me ___Hire a pet sitter ___Leave it with a neighbor ___ Other (explain)
17. Under what circumstances would you no longer be able to keep this cat? (Check all that apply. Cross out any that don’t apply)
___ It stopped using the litter box ___ It clawed my furniture/rugs
___ It began spraying ___ Someone in my family developed allergies
___ I moved to a community where cats were not allowed
___ I met someone special and he/she didn’t like cats
___ I couldn’t afford the vet bills ___ Other
18. Adopting a cat is a lifetime commitment. How long do you expect the cat to live?
___ 1-5 years ___ 5-10 years ___ 10-15 years ___ more than 15 years
19. What would you do if the cat was diagnosed with a chronic disease, such as diabetes, kidney failure, cancer, heart disease or hyperthyroidism?
__ I wouldn’t want it to suffer, so I’d have it euthanized __ I’d follow my veterinarian’s advice __ I’d learn all I could about the disease and make decisions about the cat’s care based on that knowledge.
20. Are you willing to let the cat go out...
__ Never __ On a harness and leash __ Under supervision __ It’s okay with me if the cat wants to go outside.
21. Is anyone in your family allergic to cats?
__ Yes __ No
22. Does everybody in your family want a new cat?
__ Yes __ No
23. Please list three personal references
1. ____________________________________________________________________________________________________________________________
2. ____________________________________________________________________________________________________________________________
3. ____________________________________________________________________________________________________________________________
24. Is it okay if a representative of the Howard County Cat Club visits your home to see how and where the cat would be living?
__ Yes__ No
* Like any other family member, cats can become expensive over time. Before you adopt, please think about your finances and whether you will be willing and able to provide your cats with veterinary care when needed.
* We urge you to make arrangements for your companion animals in your will. If something happens to you, your family members may not be willing or able to give your animals a home.
DRIVERS LICENSE______________________________________________________
1. Do you want the cat for yourself or is it a gift?
__ For me personally
__ Gift for other person
2. Are you a student?
__ Yes__ No
3. Do you own or rent your home?
__ Own__ Rent
If you rent, will your landlord give you written permission to have a cat?
__ Yes__ No
4. Do you have children?
__Yes __________________________Ages
__No
5. Do you have a cat or dog now?
__ Yes__ No
If you have a dog, what breed is it?_______________________________
6. How long have you had your cat or dog?
__ 0-3 years__ 3-6 years__ 6+ years
7. If no, have you ever had a cat or dog?
__ Yes__ No
8. How long did you have the animal?
__ 0-3 years__ 3-6 years__ 6+ years
9. What happened to your cat or dog?
__ I gave it to another person.
__ I turned it in to a shelter.
__ It died of (disease)______________________ at (age) _________________
__ It ran away
__ It was hit by a car.
__ It was poisoned: Do you live in the same place now? ____yes _____no
10. Have you ever turned a cat or dog in to a shelter? ___ yes ___no
If you have, why did you give the animal up? _______________________________________________________________________
11. Who is (was) your veterinarian? ___________________________________________
12. Are your pets spayed/neutered?
__Yes __No
13. Do you plan on having the cat declawed?
__ Yes__ No
14. What do you plan to feed the cat?
__ dry food only __ dry & canned food __ dry with a bit of canned food as a “treat”
__ homemade food __ raw food
15. If you moved, what would you do with the cat?
__ Take it with me __ Find a new home __ Take the cat to a shelter or rescue __ Other (explain)
16. What will you do with the cat when you’re on vacation?
___ Take it with me ___Hire a pet sitter ___Leave it with a neighbor ___ Other (explain)
17. Under what circumstances would you no longer be able to keep this cat? (Check all that apply. Cross out any that don’t apply)
___ It stopped using the litter box ___ It clawed my furniture/rugs
___ It began spraying ___ Someone in my family developed allergies
___ I moved to a community where cats were not allowed
___ I met someone special and he/she didn’t like cats
___ I couldn’t afford the vet bills ___ Other
18. Adopting a cat is a lifetime commitment. How long do you expect the cat to live?
___ 1-5 years ___ 5-10 years ___ 10-15 years ___ more than 15 years
19. What would you do if the cat was diagnosed with a chronic disease, such as diabetes, kidney failure, cancer, heart disease or hyperthyroidism?
__ I wouldn’t want it to suffer, so I’d have it euthanized __ I’d follow my veterinarian’s advice __ I’d learn all I could about the disease and make decisions about the cat’s care based on that knowledge.
20. Are you willing to let the cat go out...
__ Never __ On a harness and leash __ Under supervision __ It’s okay with me if the cat wants to go outside.
21. Is anyone in your family allergic to cats?
__ Yes __ No
22. Does everybody in your family want a new cat?
__ Yes __ No
23. Please list three personal references
1. ____________________________________________________________________________________________________________________________
2. ____________________________________________________________________________________________________________________________
3. ____________________________________________________________________________________________________________________________
24. Is it okay if a representative of the Howard County Cat Club visits your home to see how and where the cat would be living?
__ Yes__ No
* Like any other family member, cats can become expensive over time. Before you adopt, please think about your finances and whether you will be willing and able to provide your cats with veterinary care when needed.
* We urge you to make arrangements for your companion animals in your will. If something happens to you, your family members may not be willing or able to give your animals a home.
