| Homeless Pets Foundation |
Office use only |
| Cat Application |
PET NAME
DATE HP REP ADOPTION FEE CSH CHK CC |
Name
Co-Applicant
Phone
Address
City
State
Zip
Please indicate where you live:
o apartment o house
o condo/townhouse
o trailer/mobile home
How long have you lived at this address?
How many times have you moved in the last 5 years?
Do you o Own o Rent Does your landlord/lease allow pets?
o No o Yes
Is there a limit to the number of pets allowed?
o No o Yes
How many?
Name of apt complex phone
Amount of pet deposit?
Are you willing to allow a representative from The Homeless Pets Foundation to
visit your home by appointment?
o Yes o No Why?
Are You o Working o Retired
o Attending School
o Homemaker o Other
Employer's Name Work Phone
Occupation_________________________________________________________________________________
Address
City
State
Zip
Working Hours
E-mail Address
Please check any of the following reason for adopting this cat:
o Family Pet o Child's Pet
o Gift
o Companion
o Mouser o Companion for other
pet o other, please
specify
Will anyone in your household be surprised by the adoption of this cat?
o No o Yes, who
Are there any other adults living in the household?
o No o Yes If yes, please
list below
1. Name
Relation
Age
2. Name
Relation
Age
Are any family members of your household allergic to cats?
o No o Yes, What steps will you take
to accommodate the pet(s) and the household member?
Do you or any member of your household have a serious or life threatening
illness? o No o Yes,
Please explain
How many children at home?
Please list ages
How will you handle interaction between your cat and your children?
| Type of pet | De-clawed? | Age | Name |
| 1. | |||
| 2. | |||
| 3. | |||
| 4. |
| Type of pet | Age | Altered? | How long? | Describe What happened |
| 1. | ||||
| 2. | ||||
| 3. | ||||
| 4. | ||||
| 5. |
Veterinarian's Name
Phone
Address
City
State
Zip
How much do you expect to spend annually on vet care for your cat?
Have all current pets been vaccinated? o Yes o No Why not?
Have all current pets been spayed or neutered? o Yes o No Why not?
Will you de-claw your new cat? o No o Yes
Please explain
Have you ever had a problem with fleas or ticks? o No o Yes How did you handle
it?
If your cat develops an expensive medical problem what would you do?
o Have him
put to sleep since he is older o Give him to rescue group or shelter
o Other, please explain
Max hours pet will be left alone on a typical day?
What percentages of time wll the cat live indoors? %
Do any of your current pets spend any time outdoors? o No o Yes Why?
Do you have a pet door? o No o Yes
How will you handle litter box training/problems?
How will you handle scratching and or destruction issues?
Where will new cat stay when you are not at home? o Garage o Basement o Outdoors
o Free run of house
o One room of house. Which room?
o Other
Can you provide a permanent loving home for this cat for 15 years?
What circumstances, in your mind, justify giving up a cat? o Medical Problems o
Ruining furniture
o Scratching
o Moving o Divorce o New Baby o Allergies o Children Lost Interest o Spraying
o Not getting along with other pets o Lost job o Married o Medical problems o
Not getting along w/ child
o Other
Have you ever given up a pet in the past? o No Yes, Please explain
Have you ever looked at or applied for a pet with another rescue group? o No o
Yes, please list
| Reference Name | Address | City | State | Zip | Phone |
| 1. | |||||
| 2. |
| D.L. Number | State | Exp | Phone Check | Vet Check | Home Visit |
Cat Adopted? o No o Yes Name of dog:
Fee Paid $
o Cash o Check o Charge
Exp
Added donation? o No o Yes $