Name

Email Address

Phone

Cat's name you are interested in?

Address

City

State

Residential Type? Residential Type?Single-Family HouseApartmentOther

Urban or Rural Location? Urban or Rural Location?UrbanRural

Do you own or rent your home? Do you own or rent your home?OwnRent

Do you have permission to have a pet? Do you have permission to have a pet?YesNoI don't know

How long have you lived at your current address?

Are you moving soon? Are you moving soon?YesNo

Landlord Contact Information

List all household members with ages.

Any household members allergic to animals? Any household members allergic to animals?YesNo

Who would be the primary caretaker?

Explain why you want a cat.

Do all family members want a new cat? Do all family members want a new cat?YesNoI don't know

If no, please explain.

Is this your first cat? Is this your first cat?YesNo

What do you know about cats?

How do you feel about declawing a cat?

Your new cat needs to get along with what kinds of animals?

Where will your cat stay during the day?

Where will your cat stay during the night?

How long will your cat be alone during the ave. day?

Where will your cat stay when no one is home?

What will you do if your cat gets lost?

What kinds of arrangements will be made during extended absences?

List all animals in your house and if sterilized.

Are their inoculations current?

Do any of your current animals have medical conditions? (Describe)

Describe previous pets you have owned, how long they lived, and what ultimately happened to them.

Have you ever given up a pet? Have you ever given up a pet? YesNo

If yes, please explain.

You would consider giving up your pet if:

If you were unable to care for your pets, what arrangements have you made?

Are you prepared for the expenses of having a cat for the next 10-15 years? Are you prepared for the expenses of having a cat for the next 10-15 years?YesNoNot sure

Please provide your veterinary contact information.

Please provide two references (name, address, phone).

Do you understand that if an adopter cannot keep their cat, it must be returned to either MFOA or the Maumelle Animal Shelter? Do you understand that if an adopter cannot keep their cat, it must be returned to either MFOA or the Maumelle Animal Shelter?YesNo

Individuals who adopt from MFOA or the Maumelle Animal Shelter are contacted periodically for an update to help ensure that the animal successfully adjusts to their new life. If you adopt an animal from either Maumelle Animal Shelter or MFOA, do you consent to home visits after the adoption? Individuals who adopt from MFOA or the Maumelle Animal Shelter are contacted periodically for an update to help ensure that the animal successfully adjusts to their new life. If you adopt an animal from either Maumelle Animal Shelter or MFOA, do you consent to home visits after the adoption?YesNo

Any other information about you to consider?