FOR STAFF/RECEPTION USE ONLY    CAT Description of cat applying for: ID#_________-_______  Cat's Name: ________ Sex:_______Age:_______ Spay/Neutered:  Yes  No Spay/Neuter Voucher Provided:  Yes  No STAFF/RECEPTION ADOPTION OVERSEER INITIALs *__________ Date:_______________ PLEASE COMPLETE IN ITS ENTIRETY.

CAT ADOPTION APPLICATION (Please Print Clearly & Answer all Questions.)

The Hill Country Humane Society/SPCA has the right to refuse adoption to anyone.

Applicant's name_____________________________Driver's License #:____________
Local Address______________________________________________Apt#___________
City_________________________________State__________________Zip___________
Home Phone ________________Work Phone __________________ Email ___________
DESCRIPTION OF RESIDENCE: Do you Rent?______Own?_____
___House Property owner's name:____________________Phone____________
___Apartment How long have you lived here?______________________________
___Mobile-Home
___Duplex #Adults in house______#Children______Children's Ages_______


WHAT PETS DO YOU CURRENTLY HAVE IN YOUR HOUSEHOLD?
KIND        SPAY/NEUTER      KEPT WHERE?     TIME OWNED        AGE 
Dog__Cat__ | Yes___No___ | In____Out___ |_______________|__________|
Dog__Cat__ | Yes___No___ | In____Out___ |_______________|__________|
Dog__Cat__ | Yes___No___ | In____Out___ |_______________|__________|
Other_____ | Yes___No___ | In____Out___ |_______________|__________|

LIST PREVIOUS PETS
KIND       SPAY/NEUTER   KEPT WHERE?  TIME OWNED  WHAT HAPPENED TO PET  
Dog__Cat__ | Yes___No___ | In____Out___ |_________|________________|
Dog__Cat__ | Yes___No___ | In____Out___ |_________|________________|
________________________________________________________________________

·Are you at least 18 years old?______Yes_________No
·What is the name of your veterinarian?__________________________________
·Veterinarian's address__________________________________________________
·How long have you used this Vet? _______________________________________
·Who will be responsible for the daily care/feeding of this CAT? _______________________________________
·Who will financially support this CAT?__________________________________
·Reason for wanting this CAT?____________________________________________
·Where will you keep this CAT?___________________________________________
·Where will you keep this CAT when you TRAVEL?___________________________
·Do all members of this household WANT this CAT?_________________________
·If you have young children, they need to be educated on how to interact with the CAT in order to prevent bites/scratches, are you able/willing to do that?
___Yes ___No
·How long will you give this CAT to adjust to its new home?______________
·How many hours will your CAT spend alone?_______________________________
·If you must give up this CAT, what would you do with it?________________
·Would you object to a follow-up home visit by the Hill Country Humane Society/SPCA? Yes No Best day/time: ______________________________
·What amount of time will the CAT be inside?______outside?______
·If adopting an outside CAT, do you have a CAT door? ______Yes_____No
·Do you realize that an outside CAT may be run over, contract Feline leukemia, incur abscesses in catfights or be injured? ___Yes ___No

·What will you do if your CAT shows destructive behavior? (Jumping, tearing up plants/furniture, clawing furniture or running off)____________________________________________________________________________________
·Will you provide your cat a scratching post or cat tree? ___Yes ___No
·Are you planning on having this cat Declawed? ____Yes ____No If yes why do you feel the need to declaw? ________________________________________________________________________________

·Will you have your CAT SPAYED OR NEUTERED within the recommended time frame? (A surgical operation to prevent parenthood for animals) ____Yes ____No
·Where/who will perform the surgery? _______________________________________________________
·What type of balanced nutrition do you intend to provide for your CAT?
CAT Food Brand:_________________ Dry or Wet
·Will you have this CAT vaccinated annually, by a veterinarian, against infectious disease?__________ Veterinarian:_________________________
·Are you familiar with Feline Leukemia?______Yes______No

·Do you realize that Cats often live longer than 15 years and are you willing to assume responsibility for that long?______Yes_____No


·Where did you hear about the Christ-Yoder Animal Shelter/Adoption Center - Hill Country Humane Society/SPCA Adoption Program?
___Friend____TV___Newspaper___Relative___Radio___Billboard___Petfinder ___Internet ___Other
Have you applied to adopt from this shelter before today? ___Yes ___No
Date:__________________ Pet Adopted? Yes No
If yes, where is this animal now? _______________________________________________


I certify the above is true and that false information may result in nullifying this adoption. The Hill Country Humane Society/SPCA has the right to refuse adoption to anyone. I understand that no animal can be held for me.

        Signature___________________________________Date___________________

Additional notes or comments:__________________________________________________________


Thanks again for supporting the Hill Country Humane Society.

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