Adoption Application Cat Application If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Personal Data: What is the name of the cat that you would like to adopt? * First Name * Last Name * Address 1 * Address 2 City * State * Maine Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Email * Home Phone * Cell Phone Household Information Are you over the age of 18? * YesNo Why do you want to adopt a cat? (Select all that apply) * CompanionCompanion for another petHouse PetBarn CatOutdoor CatMouser Other If other, please explain: How many people do you have in your household? * Please list the names and age of each person in your household: Are all members of the household aware that you wish to adopt this cat? * YesNo Do any members of the household have any allergies to cats? * YesNo Employment Information: Employer's Name Employer's City Employer's State Maine Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Employer's Phone Number What is your position? How many hours a week do you work? Would someone be with the cat during the day? YesNo If yes, who? If you are not currently employed, how do you plan on providing for this cat's financial needs? Pet History: What kind of pets have you had in the past? (Check all that apply) CatsDogsBirdsFishHorsesFerretsRats/MiceOther Which of these do you still have? (Include age, sex, breed, and whether they are spayed or neutered) Have any of these pets ever lived with other cats before? YesNo What veterinarian do you use for any current or previously owned pets? Veterinarian Name Veterinarian Phone Number If you have other cats, have they been tested for FeLV and FIV? YesNo If yes, did they test negative or positive for FeLV and FIV? PositiveNegative Have you ever had to surrender a pet to an animal shelter? YesNo If yes, please explain the situation: Have you ever had to euthanize a pet? YesNo If yes, please explain: Have you ever had a cat declawed? YesNo If yes, please explain: Would you ever consider declawing this cat? YesNo Home information: Do you own or rent your home? * OwnRent If you rent your home, may we contact your landlord to obtain permission for this cat to live in your home? YesNo Landlord's Name Landlord's Phone Number Do you have screens on all of your windows? * YesNo Cats can live for 15 to 20+ years. Would you be willing to take responsibility for this cat for the cat's entire life? YesNo Where will the cat live? (Check all that apply) * Inside the house onlyOutsideBoth inside and outsideBarnGarageOther If other, please explain: If you were to leave your house for a few days or longer, who will take care of the cat? * If you move, would you take this cat with you? * YesNo What arrangements will you make for the care of your cat in case of an emergency or if you become unable to care for him/her? * Would you be interested in receiving future emails from Hope Harbor Animal Society about our animals and news? YesNo I certify the information provided is complete and correct to the best of my knowledge. I give my permission for any of this information to be verified. I understand that Hope Harbor Cat Counselor has the right to deny any adoption for any reason. That filling out this form does not automatically entitle you to adopt a cat from Hope Harbor Animal Society. I agree with the above statement: * Please review all the information entered above before submitting this form. What is 4+2? *