Ashley Valley Community Cats Adoption Application

Which cat are you interested in adopting?

Your name

First name Last name

E-mail

Address

Phone number

Area code Number

Date of birth

Are you employed?

Name and phone number of employer

Do you have children in the home? If so, what are there ages?

Who is your primary veterinarian?

Current primary residence

If renting, what is your landlord's phone number?

Area code Number

What is your primary reason for wanting to adopt a cat?

Where will this cat spend most of its time?

Will this cat be kept outside?

Will you keep this cat in a crate?

Yes No

Do you currently have any other pets?

Yes No

Have they been around other animals before?

Yes No n/a

Do you plan on de-clawing this cat?

Is everyone in the household in agreement to adopting a cat?

Yes No

When left alone, where will your cat stay?

Is anyone in the household allergic to animals?

Yes No

Who will be responsible for feeding the cat and cleaning the litter box?

If you move, what will happen to your cat?

Have you ever given away or "gotten rid" of an animal?

Yes No

Are you prepared to keep your new feline for its entire life up to 20 years?

Do you agree to give the cat back to us, if for any reason at any time you are unable to keep her/him?

Provide a reference that is not a family member

First name Last name

Reference person's phone number

Area code Number

May we visit your home before and after adoption?

Yes No

I have answered all questions honestly and am ready to provide a loving, caring, warm home to my new forever cat.

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