Ready to Adopt?

• Check the ones that describe the cat you would like:

  Couch Potato Goofball Constant Companion Free Spirit Party Animal Lap Cat Low Energy Senior Citizen High Energy Happy-go-lucky Not sure

• Are there any cats that you are interested in? Please list their names.

• The last cat I had was:

  never had a cat in my childhood over 2 years ago within the last 2 years I have cats now How many cats do you currently have?

• My new cat will primarily be an:

  an indoor kitty an outdoor kitty both an indoor and outdoor kitty

• My new cat needs to be able to be alone:

  over a weekend 8 or more hours per day 4 - 8 hours per day 2 - 4 hours per day hardly ever

• My new cat needs to be good with:

  children less than 5 years of age children greater than 5 years of age elderly people birds dogs cats other

• I would consider my household to be like:

  a zen garden middle of the road a carnival

• When I'm not at home, my new cat will spend time:

  in the garage in a crate inside the house in one room loose in the house in the yard free to go in or out with doggie door

• How do you feel about a mischievous cat that gets into everything?

  love them but don't want to live with one depends on the situation fine by me

• I like a cat who is by my side or in my lap when I'm at home

  a little of the time some of the time all of the time

• I want my new cat to love being with children in my home

  it's important to me some of the time most of the time children don't often come to my house

• It is most important that my new cat is:

• I am willing to budget $___ monthly care for my new cat:

  $25 - $50 $50 - $75 $75 - $100 $100+ (so I will have some for emergencies) whatever it takes

• If I experience behavior problems with my new cat, I will:

  give the cat away give the cat back to A New Leash on Life not let the cat inside again consult my veterinarian for help consult A New Leash on Life for help

Complete your employment information

• Where do you work?

  What is your title?

• What are your working days and hours?

Complete your personal information

• First name: Last name: Physical address: Physical address (cont): City: State: AL GA KY MS TN Postal code: Email address: Mobile or home number: Alternate number: What is your age?

  Do you own or rent?

  Own Rent

  If you rent, are you prepared to show proof of the pet policy?

  Yes No

• Tell us about your home life.

  Are you: Married Single Live with partner

  How many children live in the household?

  Please list their ages.

  Does anyone in the home have allergies?

  Yes No

  If yes, list your allergies.

  Does anyone smoke inside the home?

  Yes No

• Check the ones that describe the dog you would like:

  Couch Potato Goofball Constant Companion Free Spirit Party Animal Lap Dog Low Energy Senior Citizen High Energy Intelligent Hunting Dog Guard Dog Working Dog Yard Dog Smart, but not smarter than me Not sure

• Are there any dogs that you are interested in? Please list their names.

• The last dog I had was:

  never had a dog in my childhood over 2 years ago within the last 2 years I have dogs now

  How many dogs do you currently have?

• My new dog will primarily be an:

  an indoor dog an outdoor dog both an indoor and outdoor dog

• If your yard is fenced, what type of fencing?

  privacy chain link I do not have fencing other

  If other, please list:

• Check all that apply

  I have the following:

  outdoor dog pen tie-out stake and lead tie-out stake and lead Indoor crate doggie door

• My new dog needs to be able to be alone:

  over a weekend 8 or more hours per day 4 - 8 hours per day 2 - 4 hours per day hardly ever

• My new dog needs to be good with:

  children less than 5 years of age children greater than 5 years of age elderly people birds dogs cats other

• I would consider my household to be like:

  a zen garden middle of the road a carnival

• When I'm not at home, my new dog will spend time:

  in the garage in a crate inside the house in one room loose in the house in the yard free to go in or out with doggie door

• I am comfortable doing some training to improve manners such as jumping, pulling, etc.

  no would like info on obedience training yes I have done obedience training

• My thoughts on housetraining are:

  I don't want ANY accidents in my house I will be upset if my dog has accidents, but not the end of the world I don't mind if my new dog has a few accidents in the house during the first few weeks I don't mind occasional accidents I will work with my new dog on housetraining as long as it takes

• I would prefer to adopt a:

  puppy < 16 weeks puppy 4 - 12 months young adult 1 - 4 years middle-aged adult 4 - 8 years senior > 8 years

• I am willing to adopt a dog/puppy who is:

  Completely housetrained: well-behaved Mostly housetrained: completely trustworthy left alone in the house Partially housetrained: in need of some obedience training Just started housetraining: still in the chewing stage. might do some property damage Not housetrained: in need of training for EVERYTHING (all young pups)

• I am willing to budget $___ monthly care for my new dog:

  $25 - $50 $50 - $75 $75 - $100 $100+ (so I will have some for emergencies) whatever it takes

• If I experience behavior problems with my new dog, I will:

  give the dog away give the dog back to A New Leash on Life not let the dog inside again consult my veterinarian for help consult A New Leash on Life for help

Complete your employment information

• Where do you work?

  What is your title?

• What are your working days and hours?

Complete your personal information

• First name: Last name: Physical address: Physical address (cont): City: State: AL GA KY MS TN Postal code: Email address: Mobile or home number: Alternate number: What is your age?

  Do you own or rent?

  Own Rent

  If you rent, are you prepared to show proof of the pet policy?

  Yes No

• Tell us about your home life.

  Are you: Married Single Live with partner

  How many children live in the household?

  Please list their ages.

  Does anyone in the home have allergies?

  Yes No

  If yes, list your allergies.

  Does anyone smoke inside the home?

  Yes No