Cat Adoption Form CONTACT INFO * Your Name * Your Email * Street Address * City * State ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming * Zip Code * Phone Number * Phone Type HomeMobileWork * Alternative Phone Number * Phone Type HomeMobileWork HOUSEHOLD INFO * Are you over 18 ---YesNo * Do you own or rent a home Rent Own * If you rent, please tell us your landlord's name and phone number * How many children live in the home and what are their ages * How many hours each day will the adopted animal be without human companionship? ADOPTION INFO * Describe in detail the cat you're looking for * Will this be your first cat? ---YesNo * If you currently own a cat, have they been tested for feline leukemia? ---YesNoDon't KnowDoes Not Apply * If you currently own a cat, have they been tested for FIV? ---YesNoDon't KnowDoes Not Apply * If you currently own a cat, are they declawed? ---YesNoDon't KnowDoes Not Apply * Why do you want this cat? CompanionCompanion for other petBarn catHouse petMouserOffice catOther If other, please explain why you want this cat * Where will you keep the cat? ---In the houseOutdoorsFree access inside and outdoorsIn the barn * Do you have a cat or dog door? ---YesNo * Will you have the cat declawed? ---YesNoMaybe * Are you aware of the potential side effects of declawing? ---YesNo * Will you keep the cat up-to-date on vaccinations, provide proper medical care & exercise as needed? ---YesNo * Are you willing to have a representative of Pets Alive come see where the cat will be living? ---YesNo * If you move, will you take the cat with you? ---YesNo If no, please explain why not * Are you willing to take responsibility of this cat for the next 10 to 20 years? ---YesNo If no, please explain in detail * How much are you willing to spend on medical bills for your cat? NoneUp to $100Up to $500Up to $1000Up to $5000Whatever it takes What would you do if vet bills went over this amount? * Please provide your veterinarian's information - name and phone number (after submitting this form please CALL your vet & give them your permission to speak to us) : PREVIOUS PET INFO * What animals do you CURRENTLY have? Include age, sex, breed and species. * What happened to the pets you no longer have? * Are all your current pets spayed or neutered? ---YesNo * Have you ever had a pet euthanized? ---YesNo If yes, please explain further * Have you ever turned in a pet to a shelter? ---YesNo If yes, please explain the circumstances: * Have you ever applied to Pets Alive before to adopt an animal? ---YesNo If yes, when?