First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone*

Cell Phone*

​We are committed to placing homeless cats in the best possible homes. Please fill out the application below.  You will receive an email confirming the successful submission of your application.  One of our volunteers will follow up shortly.  Thank you!

Date of Application:*

Cat(s) Applying for:*

Email Confirm:*

Place of Employment: *

Date of Birth: *

Do you Own or Rent your home? (False information will result in adoption denial)*
Choose one: Rent Own

If not a homeowner, do you have the landlord’s permission to have a pet?*
Choose one: Yes No N/A

Any information you would like to add:

Landlord Name (Required to process application)*

Landlord Phone Number (Required to process application) *

Please list the FULL NAME and AGE of ALL people living in the home and their relationship to you (spouse, partner, roommate, child, etc.) ***Failure to disclose this information will result in adoption denial****

Does anyone living in your home have a cat allergy:*
Choose one: Yes No

Are you in the process of moving, or anticipating moving in the next few months? *
Choose one: Yes No

Please list your CURRENT pets: (Animal Type, Pet Name & Age):*

Please list your PAST pets: (Animal Type, Pet Name & Age):*

Are all of your currents pets spayed/neutered?:*
Choose one: Yes No N/A

Have your every surrendered or given away any pet? If so, please explain:*

Name of Veterinarian (Required to process application): In order for us to process your application, you MUST call your vet to give permission for us to get information. Failure to do this will delay the application process and you may lose out on the cat you want to adopt. *

Veterinarian Phone Number (Required to process application):*

Tell us why you are currently looking to adopt a cat:*

What is your past and/or current experience with cats?*

Have you ever DECLAWED a cat and do you plan to in the future?*

Current cat(s) and new cat(s) will be allowed:*
Choose one: Inside Outside Both Indoor Only

Please Explain:*

When you travel, who will care for the pet while you are gone?*

Under what circumstances would you not keep the pet?
Choose all that apply: Divorce Illness in family Moving New baby Chewing Litter Box problem Clawing Allergies Grew too big Shedding too much Pet ill Kids ignored pet Pets didn’t get along Not obedient enough Would not give up for any of the above

If other reason, why?*

Please provide any information that you feel may be helpful to us regarding your adoption of this cat:*

Are you financially prepared to provide regular vet visits and emergency medical care if this pet becomes ill or injured? *Due to rising veterinary costs, we recommend Pet Insurance. *
Choose one: Yes No

Do you understand that cats can live up to 20 years and adopting this cat is a lifetime commitment?*

In the event that you are no longer able to care for this cat, please include the FULL name and phone number of a family member/friend who is willing to care for this cat:

Reference #1 Name, Relationship and Phone Number:*

Reference #2 Name, Relationship and Phone Number:*

Thank you for filling out a Local Whiskers, Inc. application. By signing this form (electronically or in person), you testify that the above information is correct and true. Providing false information on this form allows Local Whiskers, Inc. to deny adoption of any animal. Providing false information also allows Local Whiskers, Inc. to seize the animal after adoption. By signing this form (electronically or in person) you give the landlord, veterinarian, personal references, and all local shelters permission to provide any information Local Whiskers, Inc. deems necessary to make a determination regarding your adoption of this pet. **Local Whiskers, Inc. accepts adoption fees in forms of cash or check.*