QUESTIONNAIRE FOR ADOPTION

NAME OF CAT: ____________________________

Adopter's Name: ____________________________________________________

Address: ___________________________________________________________

City/State/Zip: _____________________________________________________

Telephone: Home                ___________Work ____________________E-Mail Address: _____________________________

Are you employed? ______      Student ______          Place of Employment _________________________________________

What kind of work do you do? _____________________________________________________________________________

Do you rent _______  or own your home?________   Do you live in an apartment or a condominium? ___________________

Name of landlord or apartment/condominium complex _________________________________________________________

Contact person name Contact person phone number ___________________________________________________________

What floor do you live on? _____   Do you have a balcony or patio?________ Is it completely screened? _______

Do you have permission from your landlord to have this animal? ______

Do you live alone? ________   Whom do you live with? ________________________________________________

If you or someone in your household gets pregnant, what will you do with this cat? __________________________________

How many children live in your household?__________ What are the ages of these children? __________________________

Does anyone in your household smoke?______  Is anyone allergic to pets? ________

Do you presently own other animals?___________  If yes, how many? __________

Describe your other animals: ____________Are they spayed or neutered? ___________

If you have a cat, do you have a litterbox?________ Do you plan to have a litterbox? _____________

If you had a cat before, what happened to your cat? ____________________________________________________________

Have you ever surrendered an animal to a shelter or rescue agency?_____ If yes, why? ____________________________________________

What reason would compel you to give an animal up? ________________________________________________________________________

How much time would you send with your cat?  _______________________Will the cat be alone most of the day? _____________

Do you plan to keep your new cat indoors only? ________Outdoors?              Both? _____________

Do you plan to declaw your cat? _____________Do you plan to feed your cat: Moist _____Dry _____Both ______

If for any reason you become unable to care for this cat, do you have a friend or family member who would adopt

this cat? _________Person’s name and phone number: _______________________________________________________________________

If you moved from your current residence, would you take this cat with you? __________

Have you considered cost of pet ownership and are you prepared to give your pet the medical care it requires? ______________

Do you have a veterinarian? ___________Name & phone # of veterinarian ______________________________________________________________

WE WILL DELIVER THE CAT. IF THERE IS MORE THAN ONE PERSON INTERESTED IN THE CAT, WE RESERVE THE RIGHT TO MAKE THE DECISION AS TO WHO WILL BECOME THE NEW OWNER OF THE CAT. THE ADOPTION DONATION WILL BE PAID AT THE TIME OF DELIVERY.

Signature: _________________             Date_________________