First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Cell Phone*

Animal's name you want to adopt:*

How long at present address?*

What is your age group?

Who do you live with? Please list all occupants.

Number of Adults in household:

list of children's ages*

number of current pets?*

Do any household members suffer from pet allergies? If so, which ones.
Choose all that apply: Yes No Cats Dogs

home status

Renting at:

landlord name*

If renting, please provide landlord's phone number

Extra security deposit required for pets (yes-list amount required/no/I don't know)?

security deposit amount*

Employed?*
Choose one: No Yes

place of employment

employment position

length of employment

number of pets owned in the past*

Please list all current & previous pets you've owned, starting with the most recent first & answer each question for each pet. Name: Current: yes or no? Breed type: Age & Sex: Spayed or Neutered: If no longer own, what happened to the pet? *

Will the animal live with you? If not, who & where will the animal live.*

Have you ever sold, given away, or surrendered a pet to a shelter? If so, please describe the circumstances.*

Do you agree to 9 LIVES CAT RESCUE visiting your home to check on the animal you are fostering?*
Choose one: No Yes

In order to provide for any necessary medical care & nutritional requirements for this animal, I am willing to spend YEARLY:*

name of first reference*

first reference phone number*

second reference name*

second reference phone number*

Reason(s) for wanting cat (check all that apply):
Choose all that apply: Gift Barn cat Breeding Mouser House Pet For Children Companionship Replacement for a deceased pet Other

Where will this cat live? *
Choose one: Outdoor Outdoor/indoor Indoor only

How long after adoption would you start allowing your cat/kitten outdoors?*

Who will care for this cat when you have to leave (vacation/ holiday/ hospital/ assisted living)? *

What would you do if your new cat is not using the litter pan?*

How do you prevent your new cat from scratching the furniture? *

Name, phone number & city of your current veterinarian. If none, veterinarian you plan to use.*

if no veterinarian, one you plan to use:*

If you currently have a dog/cat, are you using heartworm preventative?*

If so, what kind:*

If you currently have a dog/cat, are you using flea and tick preventative?*

If so, what kind: *

Is there anything else we should be aware of?

I hereby swear that the answers given by me on this application are true and complete to the best of my knowledge and I understand the application process.*
Choose one: No Yes