CROSS OUR PAWS RESCUE

CAT ADOPTION APPLICATION

Applicant’s Name:

Date:

APPLYING FOR:

Name of Cat(s):
Breed(s):

Color(s):
Age(s):

Gender(s):
Special Needs (if applicable):

APPLICANT'S INFORMATION:

Full Name:

Address:
City:

Province:
Phone Number:

E-mail:
Address:

Age:

HOUSEHOLD INFORMATION:

What type of home do you live in?:
House Condo/Apt.:

Mobile Home:
Military Housing:

Other - please explain:

Type of Neighbourhood:
Urban:

Suburban:
Rural:

How long have you lived at your present address?: Do you own or rent your home?:

If you rent, do you have permission from your landlord to own a cat(s)?:

Landlord's Name:

Landlord's Phone Number:

Are you planning to move within the next year?:

If you decide to move in the future, what will you do with your companion animals(s)?:

HOUSEHOLD:

How many adults in your home?: Are there children in your home?: If yes, how many and what ages?:

Are there any children who frequently visit your home?: Will this be your first cat(s)?:

If no, were they: Indoor: Outdoor:

Indoor and Outdoor:

Will THIS cat(s) be an indoor only cat(s)?:

Where will the cat(s) spend the day?: Indoors:
Outdoors:

Other (please explain):

Where will the cat(s) spend the night?: Indoors:

Outdoors:
Other (please explain):

What is the purpose of this cat(s)?:

Companion:
Company for current pet:

Mouser/barn cat:
Other (please explain):

Would you consider adopting a bonded pair?:

Have you in the past or would you ever consider declawing your cat(s)?:

Do you feel you can commit to a cat(s) for the next 10-20 years?:

Are all members of your household aware of your plans to adopt a cat(s)?:

Who will be the primary caregiver of the cat(s)?:

Are any members of your household allergic to animals?:

How many hours will your companion animal be without an adult in the house?:

Which of the following would force you to give up your cat(s)?:

1. 	Divorce/separation 

2. 	Moving where pets aren’t allowed 
3. 	Scratching furniture 

4. 	Urinating/defecating on carpet and/or furniture 
5. 	Large veterinary bills 

6. 	Cat develops chronic illness 
7. 	Planning on having a baby 

8. 	Cat doesn’t get along with current pet 

Have you ever given up/surrendered a pet in the past? If yes, please explain.:

VACATION:
How often do you go on vacation?:

What will you do with your companion animal when you go on vacation?:

EMPLOYMENT:

Please provide information for all adults in the household.

Employer:
Occupation:

How long at your present job?:
Can you be contacted at your job?:

If yes, work phone number:

OTHER ANIMALS:

Do you currently own any other animals? (birds, fish, dogs, cats etc): If yes, please describe:

Are they spayed/neutered?:

If you do have other pets, how do you feel they would adjust to a new cat(s) in the household?:

Do you have a current vet?:

If yes,
Name of Veterinarian:

Address:
Phone Number:

Please describe your past pets (species, breed, age and what happened to them):

REFERENCES:

Name:
Phone Number:

Relationship:

Name:
Phone Number:

Relationship:

QUESTIONS:

Why do you want to adopt?:

What type of personality are you looking for in a cat(s)?:

(If applicable) Have you ever had a special needs animal before? If yes, describe:

Are you aware that if you can no longer keep the cat(s), you are required to return them to Cross Our Paws Rescue?:

Cross Our Paws Rescue is concerned for the well-being of our cats. To ensure we find them the best suitable home, would you be willing to allow one of our volunteers to do a scheduled home visit prior to, and/or after the adoption process?:

If no, please explain why:

I hereby certify that all information supplied by me on this application is true.

NAME:

Date:

Interviewer's Notes: