First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Work Phone
x

Cell Phone*

Driver's License #, State, DOB, and expiration:*

Cat/Kitten Name (if known)

Foster Parent Name (if known)

How did you hear about You had Me at MEOW?

Name of Spouse or Significant Other

Do you have children?
Choose one: Yes No

If Yes, Please list children ages

List any additional people in the household

Who will be responsible for the cat's care (the primary caretaker)? Feeding, cleaning the litter box, taking the cat to the vet, etc…

Has anyone in your household experienced allergies or asthma?

Are you prepared to care for this cat for 15–20 years?
Choose one: Yes No

Does anyone living in the house smoke? YES NO
Choose one: Yes No

Why are you looking to adopt a cat?

What kind of home do you live in? (House, apartment, condo, other)

How long have you lived at this address?

Do you have plans to move in the near future?
Choose one: Yes No

If yes, would you take the pet with you?
Choose one: Yes No

Do you rent or own your home?

If you rent, please enter your landlord's name, phone number, and if applicable, name of Community to verify pet security/deposit has been paid and number of pets allowed

In what areas of your home will your cat be allowed?

How many hours a day will your cat be left alone?

Where will your new cat be left when alone?

Will your new cat be an indoor, outdoor pet? (or both)
Choose one: Indoor Outdoor Both

Do you have a dog or cat door?
Choose one: Yes No

Is this your first pet?
Choose one: Yes No

How many pets do you currently have?

Current Pet 1 Name, Age, Species, Breed, Spayed/Neutered, Time in your care

Current Pet 2 Name, Age, Species, Breed, Spayed/Neutered, Time in your care

Current Pet 3 Name, Age, Species, Breed, Spayed/Neutered, Time in your care

Current Pet 4 Name, Age, Species, Breed, Spayed/Neutered, Time in your care

How many previous pets in past 10 yrs no longer in your care?

Pet no longer in your care: Pet 1 Name, Age, Species, Breed, Spayed/Neutered, Time in your care, Reason no longer with you

Pet no longer in your care: Pet 2 Name, Age, Species, Breed, Spayed/Neutered, Time in your care, Reason no longer with you

Pet no longer in your care: Pet 3 Name, Age, Species, Breed, Spayed/Neutered, Time in your care, Reason no longer with you

When do you plan to declaw your new kitten/cat?*
Choose one: Immediately 3-6 months 6 months to 1 year Maybe, not sure when Never

Name of current veterinarian and phone number, and/or previous vets used

Is there a cat behavior that would not be acceptable to you?

Were you ever in a situation where you were not able to keep a pet?
Choose one: Yes No

What would happen to the cat if something happened to you?

I agree to allow a rescue representative to perform a pre-adoption home check?
Choose one: Yes No

I am willing to stay in touch with a rescue representative after adoption to check on the animal I am adopting?
Choose one: Yes No

I am aware that the adoption fee for the cat/kitten I am considering is non-refundable?
Choose one: Yes No

I understand that applying for adoption does NOT necessarily guarantee that I will be approved. YHMAM has the right to refuse an adoption to any individual on any grounds. I give YHMAM permission to verify the information provided on this sheet. Also, I agree to provide my Driver's License Information at time of adoption if I am approved.*
Choose one: I have read, understand, and agree with this disclaimer I do NOT agree

We do not guarantee the health of any animals offered for adoption. Any time you adopt an animal, you should take it to a licensed veterinarian as soon as possible. Your animal is, to the best of our knowledge, healthy, but will need to be started immediately on a program of preventative veterinary care. Like human illnesses, these disorders can have an incubation period of up to several weeks. If the animal you adopt shows signs of illness at any point, he/she must be taken promptly to your veterinarian for treatment. *
Choose one: I have read, understand, and agree with this disclaimer I do NOT agree

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