First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
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Email*

Cell Phone*

Text/Pager Email

There are several categories that free-roaming cats fall into. Friendly Stray may belong to a nearby neighbor, may be lost or abandoned Community Cat doesn't have an owner, is cared for by one or more residents within the neighborhood. May be semi-socialized, may or may not come near its feeder or other humans. Feral Little to no human contact. Typically will run at the first sight or sound of a human. Friendly feral May come to its caretaker/feeder but not able to handle In the space below, please indicate the number of free roaming cats at your location and the category they fall under.*

Please indicate in the space below the gender of each cat at your location (if known), the approximate age (if known) and how long they have been at your location.*

Do any of the cats at your location have visible signs of injury or illness? Please describe in the space below*

Are any of the cats at your location pregnant? Are there any unweaned kittens? Are there any weaned kittens? Please indicate the number of pregnant females, the number of weaned and unweaned kittens. Please indicate how long ago you first saw the kittens and if they are eating on their own, how long?*

Are you the only one feeding the cats at your location?*
Choose one: Yes No

If other neighbors are also feeding the cats at your location, will you be able to notify them when the cats will be trapped and ensure that they will not feed on that day (or the night before if trapping will be done in the morning?)*
Choose one: Yes No

Is the address you provided on this information form, the same location where the cats are being fed?*
Choose one: Yes No

Are you the owner of the property where the cats are being fed and will be trapped?*
Choose one: Yes No

If you are NOT the owner of the property where the cats are being fed and will be trapped, have you obtained the permission of the property owner and do you certify that you will make them aware of the date the trapping will be done?*
Choose one: Yes No

What is the property type (single family residence, multi-family home, apartment complex, trailer park, other attached housing such as condominium or townhouse?)*

Are any of the cats friendly (can you hold, pick up or pet). If yes, please describe the friendly cats (color, size, any other identifying markings.)*

I understand the fee for T.N.R. services provided by DSAR is $125 per cat (does not apply to rescued kittens surrendered to DSAR for foster and eventual adoption) and that my location cannot be scheduled for T.N.R. services until the fee is paid. If DSAR is unable to complete the TNR of all cats at my location, for any reason, any amount over $100 for each cat that is TNR'd, will be refunded to me.*
Choose one: Yes No

I understand that all cats trapped at my location will be spayed/neutered and be given the age- appropriate vaccines listed on the TNR service list posted on the DSAR website and will be returned to my location after recovery (with the exception of adoptable cats/kittens surrendered to DSAR for foster and eventual adoption). I certify that I will be at the location at the appointed time when the cats are returned and that I will continue to care for and feed them.
Choose one: Yes No

I am granting permission for DSAR to be on the premises for the sole purpose of TNR, to make necessary decisions for each cat and not hold DSAR liable for any outcomes. I grant DSAR all rights, including surrender to the organization's adoption program, to make decisions in the best interest of each cat, based on it's health, level of socialization and the resources and funding of the organization.*
Choose one: Yes No