Kitten/Cat Adoption Application

YOU MUST BE HEAD OF HOUSEHOLD TO ADOPT FROM US

PLEASE READ EACH QUESTION AND FILL OUT THE ENTIRE APPLICATION - OMISSION OF INFORMATION AND/OR FAILURE TO ANSWER ALL QUESTIONS CAN RESULT IN YOUR APPLICATION BEING DECLINED.

Date *

Name of Cat/Kitten:

Adoption Fees: *

Cats - (1+ yr.) $50-$100 (depends on age)

Kittens - $125-$150 (depends on age/breed)

Senior Pets (9 yrs.+) DISCOUNTED RATES FOR SENIORS

Are you Head of Household? *

Yes

No

Are you a student and/or do you live with roommates? *

Yes

No

Please indicate your age range. *

How did you find the pet you are interested in? *

What is your primary reason for wanting a new cat? Check all that apply: *

Are you interested in adopting a cat only because your children want one?

Yes

No

Name *

Address *

Town *

State *

Zip/Postal Code *

Phone Number: *

Email Address *

1. How many members (people) are under the age of 18 yrs. in your household? What are their ages?

2. Is this your first pet (not a family pet that you grew up with) or has your last pet been deceased longer than 5 years?

Yes

No

3. If you answered Yes, please provide 2 references. One may be a family member. You can skip to Question No. 8.

Name:

Relationship to You:

Phone Number:

Name:

Relationship to You:

Phone Number:

21-30 years old	31-45 years old	46-55 years old
56-65 years old	66-75 years old	76 years and older

Companion for me	Companion for children	Companion for other pet
Gift	Rescue a Homeless Pet	Mouser