Cat Adoption Application

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Name*

First Last

Date of Birth*

Address

Street Address Address Line 2 City State ZIP Code

How long at current address? Years/Months

Do you live in:*

Home
Apartment
Mobile Home
Live with Parents

Home Phone*

Mobile or Work Phone

Your Email*

Who is your landlord?

If renting, do you have a copy of your Pet Addendum?

Yes
No

If renting or leasing, phone number of landlord.

Employer

Employer Contact Email

CAT ADOPTION INFO

Cat Gender Preference*

Male
Female
No Preference

If you have seen cat on our website that you would like to meet, list the name of the cat.

Approximate age of animal.

Type of pet personality wanted.

Is this your 1st experience with a pet?*

Yes
No

What made you decide you wanted to adopt a cat and how long have you been looking?*

What is the primary reason you want to adopt?*

Companion for self / family / pet
Gift
Other

Have you ever adopted an animal before?*

Yes
No

If 'Yes' – where did you adopt?

Have you ever given up an animal for adoption?*

Yes
No

If 'Yes' – Where did you give up the animal for adoption?

What percentage of time will your pet be:

Indoors*

Outdoors*

Do you have a cat door?

Yes
No

HOME ENVIRONMENT

Number of people regularly in your home:

Number of Adults in Household:*

Ages of Adults:*

Number of Children in Household:*

Ages of Children:*

Example: 4,6,12

Is anyone allergic to cats in your house?*

Yes
No

If Yes, please give details:

Who will be responsible for the cat?*

Will there be any regular extended periods of time your cat will be alone (other than normal work hours)?*

Yes
No

If Yes, please describe what arrangements will be made for the cat's regular and emergency care:

Name of current veterinarian or clinic:

What brand of food will you provide for your cat?*

Can you keep your new cat isolated for at least a week from your existing pets?*

Yes
No

Where will you keep your new cat isolated?*

CURRENT PETS IN HOUSEHOLD – DOGS

Do you currently own one or more dogs?*

Yes
No

How many dogs currently in the household?

Please list the ages of dogs (separated by a comma – if more than one dog)

Is each dog you own current on their shots?

Yes
No

Are all of your dogs spayed or neutered?

Yes
No

If your dogs (or dog) are not neutered – why not?

Please give percentage of time your current dogs (or dog) are kept inside and outside.

Indoor %

Outdoor %

CURRENT PETS IN HOUSEHOLD – CATS

Do you currently own one or more cats?

Yes
No

How many cats currently in the household?

Please list the ages of cats (separated by a comma – if more than one cat)

Is each cat you own current on their shots?

Yes
No

Are all of your cats spayed or neutered?

Yes
No

If your cats (or cat) are not neutered – why not?

Please give percentage of time your current cats (or cat) are kept inside and outside.

Indoor %

Outdoor %

CAT ADOPTERS:

Do you plan to declaw?

Yes
No

If you plan to declaw – do you plan to declaw:

Front Paws only
Front and Back Paws

Are you familiar with the laser declaw method?

Yes
No

Are you familiar with other alternatives to stop scratching?

Yes
No

Location of the litter box?

Please click on ALL the behaviors you are unwilling or unable to deal with, tolerate or work through until resolved:

List any other behaviors you are unwilling or unable to deal with, tolerate or work through until resolved:

Are you familiar with the following feline diseases:

Feline Leukemia?

Yes
No

Feline Infectious Peritonitis?

Yes
No

Feline Urological Syndrome?

Yes
No

Feline Immune deficient Virus?

Yes
No

Please tell us how you heard about us?

PetSmart Customer
I am a Previous Adopter
Petfinder / PetArk search
Google Search

If you were referred to us – please let us know who referred you?

I certify that the information entered above is true and that false information may result in nullifying this adoption.

I also authorize my veterinarian to release my veterinary records on my personal pets to Lost Paws Rescue of Texas.

I authorize Lost Paws Rescue of Texas to contact me by phone, email or in person at the information released in this application.

I agree to pay the adoption fee, as required. I understand that the Lost Paws Rescue of Texas adoption fees are applied to defray the costs of medical care and boarding for our adoptable dogs and cats. We are an all volunteer organization and 100% of donations and adoption fees go towards the well-being and adoption of animals in our care.

I agree to all provisions of the Lost Paws Rescue of Texas contract. I acknowledge that if I break the contract terms – I may be subject to criminal and civil prosecution.

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Cat Adoption Application

Cat Adoption Application Form