First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Name of cat interested in adopting?
Choose an animal: DUDLY

Are you interested in adopting

Are you at least 21 years old?*
Choose one: Yes No

What is your age?*
Choose one: 18-20 years old 21-30 years old 31-40 years old 41-50 years old 51-60 years old 61-70 years old 71 years or older

Are you currently a student?*
Choose one: Yes No

If yes, *
Choose one: Yes No N/A

Permanent address:*

How long have you been at your current address?*

Number of adults in household.*

Number of children in household:*

Please list all Adult residents in your home (including yourself). Be sure to provide Ages, and Relationships to you.*

Do you have Children in the home or Children who frequently visit your home? If yes, please provide their ages and relationship to you:*

How will the children be introduced to the cat?*

Have the kids previously been around cats?*
Choose one: Yes No

Do you plan on leaving the child alone with the cat?
Choose one: Yes No

Who will be responsible for taking care of the cat?*

Is everyone in the household willing to make a lifetime commitment to the new cat?*
Choose one: Yes No

If not, why?

Does anyone in the home have allergies? Yes or No. If yes, What kind of allergies?*

I live in a:*
Choose one: home apartment condo mobile home

That I*
Choose one: Own Rent Live with Parents Live with Roommates

If you rent, do you have your landlord's permission to have/own a cat?*
Choose one: Yes No N/A

Landlord's Name and Phone Number, if you own your home or live with parents, please enter your or your parents info:*

Do you currently have other pets in the home?*
Choose one: Yes No

Do your pets go outside? If yes, explain:*

Please list all pets currently in your home. Please provide all details so we can ensure a great match.

For each of your pets, please provide the following: Name, Species, Breed, Age, Gender.*

Are your current pets spay or neutered? If not, why?

Have you ever owned cats that you no longer own? (Yes/No). If so, please give a brief description of what happened to the cat.*

Have you ever given up a cat? Yes/No. If yes, why?*

Have you ever adopted an animal from TCHS before? *
Choose one: Yes No

If so, do you still have it? (Yes/No) If not, why?*

How long do you usually keep a pet?*

Have you ever given up an animal due to moving?*
Choose one: Yes No

If yes, please explain:

What pets have you owned in the last 5 years that you do not currently own? Please tell us about these pets, the types of pets, including their ages, how long you owned them, and what happened to the pets.*

What is the main reason you want a cat?*

I also want it to be (check all that apply)

Other:

If the cat is a gift, for who?

Temperament preferred (check all that apply)

Keep in mind that an affectionate kitten can grow up to be an aloof cat, no matter how much love you give it. How would you handle that?*

I would like my new cat to get along well with (check all that apply):

Other

Do you plan to declaw your new cat?*
Choose one: Yes No

Are you familiar with the way to train a cat to use a scratching post?*
Choose one: Yes No

Are you willing to put a collar and ID on your cat? Yes or No AND Why or Why not?*

Are you aware you need to properly introduce your cat or kitten to its new litterbox?*
Choose one: Yes No

Do you know how to gradually introduce new pets to old?*
Choose one: Yes No

Please ask us, we are experts and this way we can avoid accidents from which you and the cat cannot recover.

Are you familiar with life-threatening F.L.U.T.D (Feline Lower Urinary Tract Disease), formerly known as F.U.S (Feline Urologic Syndrome) symptoms?*
Choose one: Yes No

How long to you plan on keeping the cat?*

If you have any problems with the cat's behavior, who will you call for advice?*

If you must give up the cat, what would you do?*

Name of Vet and Phone number, if you do not have one please state that you will be looking for one to establish with:*

I understand that in order to be considered as an adopter I must:

• Be at least 21 years of age.
• Have a valid driver's license or other government issued ID.
• Have proof of the knowledge and consent of your landlord if renting.
• Be willing and able to provide proper care, training, and medical treatment.

I certify that all of the information provided in this application (in its entirety) is true and correct as of the date of submission, and I understand that my application may be denied if false information is given. 

I agree that if the cat(s) being adopted does not work out for whatever reason, I will return the cat to TCHS.

I understand that the submission of this form does not guarantee I will be approved to adopt a cat from TCHS. I understand this application will be reviewed and evaluated based on what TCHS feels will be the best match for the cat and for myself.

I agree*
Choose one: I agree