Habitat for Cats Adoption Application Please enable JavaScript in your browser to complete this form.Date *Name *FirstLastCo-Applicant NameFirstLastAddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCell PhoneAlternate PhoneEmail *Do you rent or own your residence?RentOwnHow long have you lived at this address? *If renting, list name & phone of landlord: *FirstLastLandlord Phone *Does your landlord or your lease allow pets? *YesNoList the number of children & their ages living in household? * Have over at Are you over 20 years of age? *YesNoDoes anyone living in your household have allergies? *YesNoIs this cat/kitten a gift for someone? *YesNoDo you currently have a cat or kitten? *YesNoIf NO, have you ever had a cat or kitten? *YesNoIf you no longer have a cat, explain what happened to the cat:Has your current cat(s) been diagnosed with Feline Leukemia or Feline AIDS? *YesNoNot ApplicableHave you ever had, or currently have a declawed cat? *YesNoAre you considering having this cat(s) declawed? *YesNoDo you plan on letting this cat go outside? *YesNoList the number, kind & ages of animals living in household: *If you already have a cat is it spayed/neutered? *YesNoNot ApplicableName of your veterinarian: *Are you able to financially afford annual and some emergency veterinary care during this cat’s lifetime? *YesNoIf you had to move, would you be willing to find a “pets allowed” living situation, and make choices about your living arrangements, roommates, travel plans, etc. with the cat(s) welfare in mind? *YesNoI acknowledge that the information I have provided on this application is true and I authorize Habitat for Cats to contact my veterinarian(s), and landlord to verify said statement. I also recognize that any misrepresentation or omissions may result in the loss of privilege to adopt from Habitat for Cats. *I agreeSubmit
