Cat Adoption Application Welcome to Helping Strays adoption program. We request the following information so that we can assist you in the selection of a new cat that will fit your home and lifestyle as a lifetime companion. This form and a consultation with a Helping Strays representative are designed to help you find the cat most compatible with your lifestyle. To be considered as an adopter, you must: Be 18 years of age or older Provide government issues identification Helping Strays reserves the right to refuse adoption to anyone. No animals(s) will be adopted to prospective owners who mislead or fail to provide information on this Application. Applicant Info First Name * Last Name * Street Address * City * Postal Code * State/Province * Phone Number * Email * Where did you see or hear about this pet? * In a few words, please describe the personality of your perfect pet: * Will this be your first pet? * Yes No If not, what pets do you currently have in your household? Name Breed Type Spayed/Neutered Keep Where Age Name Breed Type - None -DogCatOther Spayed/Neutered - None -YesNo Keep Where - None -InOut Age Name Breed Type - None -DogCatOther Spayed/Neutered - None -YesNo Keep Where - None -InOut Age Name Breed Type - None -DogCatOther Spayed/Neutered - None -YesNo Keep Where - None -InOut Age Name Breed Type - None -DogCatOther Spayed/Neutered - None -YesNo Keep Where - None -InOut Age Are they current on vaccinations? Yes No Don't Know Have they been tested for feline leukemia/FIV? Yes No Don't Know Please list pets you have had in the last 5 years who are no longer with you. Briefly describe what happened to them. (ie passed away/turned into shelter/rehomed/euthanized) * Who is your Veterinarian? Phone Number The veterinarian will have my pet records under the owner name of - Are you aware of the cost of annual vaccinations and testing and willing to provide this necessary care? * Yes No If you have pets, will they (or it) adjust to a new pet entering the household? Easily Some Tension Don't Know Requests assistance with introductions I am adopting this cat/kitten for: * Human Companionship Pet Companion House pet Barn Cat Mouser Office Cat Other (explain) why_explain How many adults, over the age of 21, are in your household? * How many children? * Children's ages? Does any member of your household have an allergy to cats? * Yes No Don't Know Where do you live? * House Apartment Condo Mobile Home Other where do you live other Do you own or rent your home? * Own Rent If you rent, does your lease allow pets? Yes No If you rent, what is your landlord's name to verify approval of a pet? Phone Where will you keep the cat? * In the house Outdoors With free access both indoors and outdoors In the barn Other (explain) keep_other Do you have a cat or dog door? * Yes No How will you provide for your cat's physical and mental exercise while protecting your belongings? * Are you planning to have this cat declawed? * Yes No Are you aware of the potential side effects of this operation? * Yes No Have you ever applied or adopted from Helping Strays or Humane Society of Monroe County? * Yes No If yes, when? Are you willing to have a representative of Helping Strays come to see where the cat will live? * Yes No If no, explain Why have you selected this particular pet? * Are you willing to take responsibility for this cat for its entire life, potentially up to 20 years? * Yes No If no, explain If you are interested in a specific cat/kitten please give us their name * Additional Comments from applicant Thank you for providing this information. Your application along with others for this pet will be reviewed and this pet will be placed in what Helping Strays feels, is the best possible home. Helping Strays * 4221 Hanover Rd * Columbia, IL 62236 * (618) 939-PETZ (7389) * www.HelpingStrays.org Leave this field blank