Cat Adoption Application

 

GENERAL INFORMATION

Name:



Address:


Street Address Apt./Unit #

City



  
State             Zip Code

Telephone Numbers:


Home


Work


Cell

E-mail address:



Best way to contact you:  

Home Phone
Work Phone
Cell Phone
E-mail

Best time to contact you:



Why have you decided to adopt a cat?

If you are interested in adopting a particular FCHS cat or cats, what is his/her/their name(s)?

Why did you choose this/these particular cat(s)?

If you have not yet chosen a cat, what type of cat are you looking for?

Companion for: (check all that apply)

Myself/family
Another pet
Friend or relative
Other

Are you over 18?

Yes
No

 

HOME ENVIRONMENT

Number of adults, including yourself, at home:

Number of children at home:



Please list the names of all people, including yourself, living at home, and the ages of those under 18, and whether they agree with getting a new cat.

   Name:   Age:    Agrees     Disagrees

   Name:   Age:    Agrees     Disagrees

   Name:   Age:    Agrees     Disagrees

   Name:   Age:    Agrees     Disagrees

   Name:   Age:    Agrees     Disagrees

   Name:   Age:    Agrees     Disagrees

   Name:   Age:    Agrees     Disagrees



Do you  own or rent your home?  

Own
Rent

If owner:
Single Family
Condo/Townhouse
Other

If renter:
 Apartment
Mobile Home
Other    

Does your lease allow cats?
Yes
No 

If yes, what is the weight limit?
   

Does your lease contain specific
breed limitations or restrictions?
  

Landlord's Name:     
Landlord's Phone:    


 

 

 

Cat SPECIFIC INFORMATION

Where will your cat spend the majority of the time?  

Indoor Only
Mostly Indoor
Indoor/Outdoor
Outdoor only


Where will your cat be kept when alone?  

Where will your cat sleep?  

How will you encourage and reinforce appropriate behavior?

How will you prevent/manage inappropriate behavior?  

 

If you go away for a few days, or on vacation, who will take care of your cat?

What will you do with your cat if you have to move?

Does anyone in your family have allergies to dander or hair ?

Yes
No

Owning a cat is a serious financial responsibility. Are you prepared financially to spend a MINIMUM of $200 per year for veterinary care, (including routine vaccinations, heartworm preventative medication and flea/tick preventative medication), food and expenses?

 Yes
No




A well-cared for cat may live 15 years or more. Does your lifestyle, career and family plans allow you to make this commitment?

 Yes
No

 

Under what circumstances would you return the cat to the Franklin County Humane Society?

 

PET OWNERSHIP

Please list all the companion animals you have had as an adult. If you have had more than five, list the five most recent.
  Name:   Type:   Age: Number of years with family: Spayed or neutered? Indoor,
outdoor,
or both?		 What happened to the pet?
Yes
No

In
Out
In/Out

Yes
No

In
Out
In/Out

Yes
No

In
Out
In/Out

Yes
No

In
Out
In/Out

Yes
No

In
Out
In/Out


Have you ever had to give up a pet for any reason?


Yes
No

If yes, what happened to the pet?

 

INFORMATION ABOUT YOUR VET

Veterinarian's Name:
Veterinarian's Phone Number:
Name of Veterinarian's Practice :

May we contact your vet for a reference?

Yes
No

 

REFERENCES

Please list two references.

   Name:

   Phone Number:

   Address:



   Name:

   Phone Number:

   Address:

When you have completed all your answers, please press the button and your application will be emailed to our adoptions coordinator.

 

THANK YOU FOR COMPLETING THIS APPLICATION AND FOR YOUR INTEREST
IN ADOPTING A cat FROM FRANKLIN COUNTY HUMANE SOCIETY

 

Franklin County Humane Society,  PO Box 338, Youngsville, NC 27596,  (919) 990-1045,  fchsncinfo@yahoo.com
Voice Mail Checked Daily

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