First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Best Contact Phone Number*

Which cat are you interested in adopting?*
Choose an animal: Amber Barn Cats Bluebell (must be adopted with Juliet and Juliet) Cary (must be adopted with Grant and Grant) Cleo Colby Darla (Courtesy Post) Falcon Gonzo Grant (must be adopted with Cary and Cary) Isobel Jack Juliet (must be adopted with Bluebell and Bluebell) MerryBerry (must be adopted with Taylor and Taylor) Noel Penny Rani Rochelle Rory Ruby Saffron Skylar Taylor (must be adopted with MerryBerry and MerryBerry) Teak Wilhemina

Please tell why you are interested in this specific cat/kitten?*

The cat that I am interested in adopting must get along with (Check all that apply)

Employer

Please describe your housing situation*
Choose one: Own my own home Rent Live with parents

In what type of home do you live*
Choose one: Apartment Condominium Duplex Home Military Housing Mobile Home Townhouse University Housing (Dorm)

Please indicate how long you have been at your current address*
Choose one: Less than 1 month 1 month to 1 year Longer than 1 year

Please provide the names of all the people in your household (please include the age of any children):*

What is your household's general noise and activity level?*
Choose one: Low Moderate Active Very Active

Does anyone in your household have allergies to cats?*
Choose one: Yes No

How much time are you away from the home during the day and your cat will be alone?*
Choose one: Home all day Out part time (< 8 hours) Away most of the day (> 8 hours)

Do you agree to keep your cat indoors at all times?*
Choose one: Yes No

Please list all current pets residing in your household that would interact with your new cat (Please provide species, name, age, spayed/neutered, length of time you have owned this animal)*

If you answered yest to having current pets, do you keep all pets indoors at all times?*
Choose one: Yes No

Do your current pets have a veterinarian? If yes, please provide name and telephone number*

Do you plan to declaw your cat? If so, why?

Are all your current pets up to date on their vaccinations and spayed/neutered?*
Choose one: Yes No NA; no current pets

Please list all past pets (Include species, name and how long you had the pet, reason pet is no longer with you)*

What would you do if you could no longer care for your cat? *

How much do you anticipate it will cost to own this cat per year?*
Choose one: Less than $100 $100 to $500 Greater than $500

Do you think it is acceptable to give up a pet or have you ever given up a pet? If yes, please explain*