Adoption Application Form Contact Information Full Name: Address: City, State, ZIP: Email: How long at this address: Cell Phone: Home Phone: Are you interested in a particular cat? If so which one? Family & Housing How many adults/children are there in your home? (Please give ages and their relationship to you): What type of home do you live in? (Single family, town home, apartment, farm, etc.): Please describe your household: ActiveNoisyQuietAverage If you rent, please give the rules governing pets and the landlord’s name and number (by providing this information you are allowing A Cat’s Tale to contact your landlord): Are you willing to let a member of A Cat’s Tale visit your home? YesNo Does anyone in the family have a known allergy to pets? YesNo Are you aware of the veterinary costs associated with owning a pet? How much do you expect to spend on vet costs per year? Where will the pet stay during the day? Where will this pet sleep? How many hours a day will your new pet be left alone? Where will the pet stay while home alone? How many hours a day/night will the pet be indoors? How many hours a day/night will the pet be outdoors? Other Pets What other pets do you have (specify type/breed and number)? Are these pets spayed/neutered? We realize sometimes placements of certain pets don't work out. Have you ever had to re-home or surrender a pet? Please explain the circumstances. Have you ever owned a pet you no longer have? If so, what happened to the pet? Who will be responsible for this pet? If this person can no longer care for the pet who will? Pets sometimes chew furniture, claw furniture, carpets/drapes etc. They can also urinate on rugs, floors, etc. How will you deal with these problems should they occur? Please state what circumstances would cause you to re-home this pet: Who will care for the pet when you are out of town? What will happen if you move and cannot take the pet with you? Name and Phone of Veterinarian: All of the information I have given is true and complete. This pet will reside in my home as a pet. I will provide it with quality food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian. If I can no longer keep this pet for any reason I agree to return it to A Cat’s Tale Rescue. E-Signature (Full Name): Date: Δ