The Humane Society of Charles County, Inc. 

                           Cat Adoption Application                       rev 04/04

 

 

Home

Please note that although adoption applications are considered in the order they are received, the pet is not automatically approved to the first request.  We try to match pets and people to find the placement that works best for everyone.  Additionally, we keep a list of people looking for certain types/breeds of animals and may call them before considering new requests for a particular animal.  All persons living in the household should be involved in choosing a pet.  The primary caretaker must approve the selection.

 

 

Cat’s Name ________________________________  Date_________________

 

Your Name: ________________________________ Co-Applicant’s Name:___________________________

 

Address:________________________________________ City:______________ State:_____ ZIP_________

 

Home #: _____________________ Work #: ________________________ Cell # _______________________

 

Length of time at this address:___________ Is it a house _____ townhouse _____ or apartment? ________

 

Do you own your home? ________ Rent?________ Military housing?________Live with parents?_______

 

If renting, name & phone # of landlord ___________________________________

 

Qualities you desire in a cat:

 

q       Good with kids (now or in the future)        Good with dogs         Good with cats        Independent

 

q       Lap cat             Active, loves to play           Calm, quiet    Other _________________________________

 

What kinds of cat behavior do you find undesirable?  ____________________________________________

 

How would you deal with these issues?  ________________________________________________________

 

Will your cat go outside? __________________________  Will it be de-clawed? ______________________

 

Does any member of your family have allergies to animals? _______________________________________

 

What will happen to the cat if you have to move?  _______________________________________________

 

Have you ever applied for or adopted an animal from this shelter?  Yes _______  No ________

If yes, when?_____________________  What was the outcome?____________________________________

 

What veterinarian/veterinary hospital sees & vaccinates your pets?  _______________________________

May we contact them? ______________  Phone number (if known) ________________________________
PLEASE TELL US ABOUT YOUR HOUSEHOLD:

 

Cat Experience:       first time owner         have had one or two         knowledgeable & experienced

 

Home Atmosphere:       busy/grand central station        some activity        calm, low-key

 

What changes do you anticipate to your lifestyle within the next 5 to 10 years (check all that apply)

 

                   having children        moving         roommates changing        job transfer  

     

                   acquiring other pets           other _____________________________________________

 

Is anyone home during the day? ________ If yes, who? ___________________ When? ________________

 

How many adults live in your home?_______ Children?_________ Ages of children?__________________

 

Where will the cat be kept:

 

During the day? _____________________________   At night?____________________________________

 

Who will care for the cat when you’re on vacation?  _____________________________________________

 

How many hours a day will the cat be alone?   __________________________________________________

 

Please list all of the animals you have owned or lived with (starting with the most recent or current):

Type & Breed of Animal

(eg: dog-Beagle,

cat-Persian)

Name of Pet
Age
Sex

Spayed or Neutered?

yes or no

When did you own this pet?

(eg:1990-1998)

Where is/was

the pet housed?

Do you still own this pet?  If no, what happened?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                      

 

 

 

 

 

 

 

 

 

 

I certify that all the information is this application is true, and I understand that false information may void this application.  I understand that The Humane Society reserves the right to decline any adoption request.

 

Signature _____________________________________________      Date __________________________

 

(for staff use only) ________________________________________________________________________

 

________________________________________________________________________________________