Applicant name:_________________________________________________________________________
Address:_______________________________________________________________________________
City, State: _______________________________________ZIP: ________________________________
Home phone: ______________________________Work phone:_________________________________
Home e-mail: ________________________________Work e-mail: ______________________________
Employer: _____________________________________Occupation:______________________________
1. What type of cat are you interested in?
❑ Male ❑ Female ❑ Kitten (under 5 months) ❑ Adult ❑ Long Hair ❑ Short Hair
Name of cat you are interested in: _________________________________________________________
Personality type: ___________________________Color:_____________________________________
2. How many people currently reside in your household? ________________________________________
3. Any children in the household? ❑ Yes ❑ No List ages:______________________________________
4. For whom are you adopting the cat? ❑ Self ❑ Gift
5. Does any member of the family have any allergies to animals? ❑ Yes ❑ No
If yes, explain:_________________________________________________________________________
6. Who will be responsible for the cat's care? _________________________________________________
7. Where do you live? ❑ Apartment ❑ Condo ❑ Farm ❑ Mobile home ❑ Townhouse ❑ House
8. Do you own or rent your residence? ❑ Own ❑ Rent
If you rent, what is name of landlord and phone number? ________________________________________
9. Are companion animals (pets) allowed? ❑ Yes ❑ No ❑ Not sure
10. Where will the cat be kept? ❑ Indoors only ❑ Both in/out
11. If outdoors, will the cat be ❑ attended ❑ unattended ❑ collar & tags?
12. Will anyone be home during the day? ❑ Yes ❑ No How many hours will the cat be left unattended? ____________________________________________
13. What food do/will you feed your cat(s) ___________________________________________
14. When no one is home, where will the cat be kept? __________________________________________
15. If you move, what will you do with the cat? _______________________________________________
16. What provisions have you made for your companion animal (pet) in the event of your illness or death?
_____________________________________________________________________________________
17. Does anyone in your household smoke? Y/N If yes, where? ________________________________
18. Have you ever had a companion animal (pet) before? ❑ Yes ❑ No
19. Describe those companion animals (pets) you still care for or that are living in your household.
Name Breed Age Neutered? Kept where Time in your care
20. Describe those companion animals (pets) you no longer care for:
Name Breed Age Neutered? Kept where Time in Reason no
your care longer with you
21. Are your companion animals current on their vaccinations? ❑ Yes ❑ No
22. Please provide name of your veterinarian: ________________________________________________
23. Please provide telephone number of your veterinarian: _______________________________________
24. Are you financially able and willing to provide annual checkups, vaccinations, and ANY medical care
necessary? ❑ Yes ❑ No
25. If you have a dog, is he/she permitted to run loose? ❑ Yes ❑ No
26. What precautions would you take to properly introduce a new cat into your home if you have other
animals (a dog, bird, rabbit, another cat, etc.)? _____________________________________________________________________________
27. What will you do if your new cat does not get along with your present companion animals? ____________________________________________________________________________
28. Are you planning on declawing? ❑ Yes ❑ No ❑ Not sure
29. Have you ever adopted an animal from a rescue/animal control agency? ❑ Yes ❑ No
30. Have you ever had an application rejected for adoption of an animal from a rescue/animal control
facility? ❑ Yes ❑ No If yes, explain: _______________________________________________________
31. Why do you want to adopt a cat?________________________________________________________
_____________________________________________________________________________________
32. If a disciplinary or behavior problem arises, what steps will you take to work on it? ___________________________________________________________________________________
_________________________________________________________________________________________
33. Are you familiar with your local animal control laws? ❑ Yes ❑ No
34. Are you willing to sign legal pet adoption papers? ❑ Yes ❑ No
35. Do you agree to permit a visit to your home by appointment? ❑ Yes ❑ No
36. If applying for a Manx, have you owned one before and/or do you know the possible special needs?____________________________________________________________________________________
________________________________________________________________________________________
REFERENCES:Please list people other than family who you have known for at least 5 years.
Name:
Phone Number:
Name:
Phone Number:
Name:
Phone Number:
By signing this form, I/we acknowledge that all information on this form is true and correct. I/we understand that any misrepresentation of fact may result in TCR refusing adoption privileges to me/us. If my/our request for adoption is approved and later TCR discovers the above information is not true or correct, TCR reserves the right to remove the adopted cat from my home.