Kitten of interest:    Date: 

Name of applicant:		Email:	*Required
Occupation:
How long at job:		Work hours:

Mate/Spouse:
Occupation:
How long at job:		Work Hours:

Home Address:
City:		State:		Zip:
County:
Home Phone:		Work Phone:
Cell Phone:
Email:

Type of residence:  House Apartment Town House Condo Mobile Home Student Housing Military Housing Other

Do you  Rent   Own

How long at your home (years, months)? 

Do you intend to move within the next year?  Yes  No

If you rent, do you have your landlord's permission to have a pet?  Yes  No

Landlord's Name:
Phone Number:
Address:
City:		State:		Zip:

Do you have children?   Yes  No

If yes, name(s) and age(s):

Do you have a roomate?  Yes  No

If yes, do they agree to have a pet?  Yes  No

Anyone with allergies?  Yes  No

If yes, please explain:  

Who is this pet for?  Self Spouse Child Family Gift Other (note below)

If other, please specify: 

Why do you want a cat? (Check all that apply)  House Pet  Companion for family  Companion for children
Companion for other pet  To breed  Gift for (specify below)  Mouser  Other (specify below)

If gift or other, please specify:  

When would the cat be inside?  All the time At night In and out Never Other (specify below)

When would the cat be outside?  All the time At night In and out Never Other (specify below)

About what percent of the time will the cat be left alone? 

Where will it be when left alone? 

What area(s) of the house will the cat be allowed into?  

What area(s) of the house will be off limits to the cat? 

Where do you plan to put the litter box? 

Where will the cat sleep at night? 

Do you plan to declaw your cat?  Yes  No

Have you declawed a cat in the past?  Yes  No

How do you plan to provide for the cat when you are out of town?  

What would you do if you had to move and had trouble finding a place that allowed pets?

If the cat claws your furniture or carpet, what would you do?

What would you do if the undesirable behavior continued?

Under what circumstances would you not keep the cat?

What would you do in that event?

Are you willing to live with an animal that could be destructive at times?  Yes  No

How would you rate your cat experience?  1st Time Owner Beginner Intermediate Advanced

Other: 

What would you do if you or your spouse/significant other became pregnant? 
Find the cat another home  Keep the cat  Return the cat to Meows Without Moms 
Give cat to family member/friend temporarily until baby is born 
Make the cat an outdoor cat so we wouldn't have to clean litter box 

Do you feel a cat should wear a collar and ID tag, even it's an indoor only cat?  Yes  No

Which of the following reasons might prompt you to give up your pet (choose all that apply)?

	Excessive Meowing			Biting
	Scratching Family Member			Scratching carpet or furniture
	Moving			Divorce
	Poor Mouser			Shedding
	Planning on having a baby			Financial problems
	Allergies			Won't always use litterbox
	Not friendly with guests (hisses)			Excessive vet bills
	Aggressive with dogs			Aggressive with other cats
	New spouse/partner doesn't like cats			Cat's health problems (hip dysplasia, overactive thyroid, heart murmur. etc.)
	None of the above			Other:

Are you prepared for veterinary expenses such as emergency medical problems (especially in old age), that you will incur when adopting this cat for its entire life?  Yes  No

Animals currently living in your household or under your care:

Name	Type/Breed	Age	Sex	Spayed/Neutered	Last Vet Visit
			Female Male	Yes
			Female Male	Yes
			Female Male	Yes
			Female Male	Yes
			Female Male	Yes

      

What pets have you had in the past?

What happened to the ones you no longer have?

What would happen to the cat if you moved locally?

Out of state?

Out of the country?

Do you have a regular veterinarian?

If so, veterinarian's name: 

Name of clinic: 

Street Address: 

City:    State:    Zip: 

Phone: 

Will you be able to live with hair and scratches on your furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times?  Yes  No

Remember, pets are an inventment of your time and money.  Can you afford to provide medical care, grooming, proper diet, proper shelter and exercise for your new pet?  Yes  No

Are you able to make a long term committment to care for your pet for its entire life span, which could be as much as 10-20 years?  Yes  No

Under what circumstances would you not be able to keep this kitten/cat?

Have you ever had to give up a pet in the past?  Yes  No

If so, please explain:

Would you be open to a home visit from a representative of Meows Without Moms?  Yes  No

Personal References:

Name: 

Phone: 

Relationship: 

Name: 

Phone: 

Relationship: 

Why do you want to adopt an animal?

What type of personality are you looking for?

If necessary, how will you dicipline this animal?

What would you do if someone in your household became allergic to the cat after you adopted it?

Please read the following carefully and initial if appropriate:

  I understand that I will not be allowed to adopt from Meows WIthout Moms unless I am at least 18 years of age.  By initialling to the left, I certify that I am at least 18 years of age.

  I understant that I must have the knowledge and consent of all adults living in my household to adopt and resident animals (if applicable).  By initialing to the left, I certify that I have the knowledge and consent of all adults living in my household to adopt and resident animals.

  I understand I must have my landlord's consent to bring an animal onto the property to live.  By initialing to the left, I certify that I have permission from my landlord to bring an animal onto the property to live (or my own home)

  I understand that Meows WIthout Moms has the right to deny my application with or without reason.  By initialing to the left, I certify that I understand that denial of my application is always the right of Meows WIthout Moms.

  I certify that the information given by me in this application is true and complete.  I further understand that any falsified information that I give will terminate the action on the adoption process.  I hereby authorize release/disclosure of records and/or other information concerning all of the above inquiries, including, but not limited to employment information, tenancy information and veterninarian records.  Meows Without Moms reserves the right to refuse any adotion it considers unsatisfactory.