Cat Adoption Form Personal Information First Name* Last Name* Physical Address* Physical Address (con't) City* State* -- Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Madison County, AL Resident?*Madison County, AL Resident? Yes No Email address* Primary Contact Number* Secondary Contact Number What is your age?* Do you own or rent?* Own Rent Live with Parent(s) or Relative(s) Live in Dorm, Military Quarters, etc Are you prepared to show proof of pet policy?Are you prepared to show proof of pet policy? Yes No Marital Status?* Single Married Divorced Widowed What is your spouse's name?* Is your spouse currently employed?*Is your spouse currently employed? Yes No Where does your spouse currently work?* What is your spouse's job title?* What are your spouse's typical work days and hours?* How long has your spouse been employed at current employer?* Are you currently employed?*Are you currently employed? Yes No Place of Employment* Job Title* Work Days & Hours?* How long employed there?* How many children live in your home?* 0 1 2 3 4 5 or More Does anyone in your home have allergies?*Does anyone in your home have allergies? Yes No What kind of allergies?* Does anyone smoke in your home?*Does anyone smoke in your home? Yes No Pet Information Do you currently have any pets?*Do you currently have any pets? Yes No Do you currently have any dogs?*Do you currently have any dogs? Yes No Current Dog(s)* Name(s), age(s), breed(s), gender(s), spayed/neutered? Are they all on heartworm prevention?*Are they all on heartworm prevention? Yes No Do you currently have any cats?*Do you currently have any cats? Yes No Current Cat(s)* Name(s), age(s), breed(s), gender(s), spayed/neutered? Are any of them de-clawed?*Are any of them de-clawed? Yes No If any of your current pets are not altered, are you willing to have the animal(s) altered prior to adoption?*If any of your current pets are not altered, are you willing to have the animal(s) altered prior to adoption? Yes No N/A Why? Aside from any current pet(s), list all of the pets you have had in the past 5 years and what happened to them:* Name, Dog/Cat, Spayed/Neutered, Why are they gone? Current & Previous Veterinarians Serious Questions Which cat(s) are you interested in?* If you intend to adopt more than one cat, please separate their names with commas. I would consider my household to be like...*I would consider my household to be like... a zen garden middle of the road a carnival The last cat I had was...*The last cat I had was... I've never had a cat In my childhood Over 2 years ago Within the last 2 years I already have a cat(s) My new cat needs to be good with*My new cat needs to be good with Children < 5 Children > 5 Birds Elderly People Cats Dogs Other Check all that describe the cat you want:*Check all that describe the cat you want: Couch Potato Goofball Constant Companion Free Spirit Party Animal Lap Cat Low-Energy Senior Citizen High-Energy Happy-Go-Lucky My new cat will primarily be an*My new cat will primarily be an Outdoor Cat Indoor Cat Both Outdoor and Indoor Cat My new cat needs to be able to be alone*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 When I'm not at home, my new cat will primarily spend time*When I'm not at home, my new cat will primarily spend time In the garage In a crate inside my home In the yard Loose in the house In one room Free to go in or out with doggie door How do you feel about a mischievous cat that gets into everything?*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 want my new cat to love being with children in my home*I want my new cat to love being with children in my home? It's not important to me Some of the time Most of the time All of the time It is most important that my new cat is* I am willing to budget $__ monthly to care for my new cat*I am willing to budget $__ to take care of my new cat. $25-$50 $50-$75 $74-$100 > $100 Whatever it takes If I experience behavioral problems with my new cat, I'll...*If I experience behavioral problems with my new cat, I'll.... Give him or her away Give him or her back to ANLOL Call a trainer Consult my veterinarian Consult A New Leash on Life Upon successfully submission, you will be redirect to a different page. If do not get redirected, please scroll up and check the form for errors. Type the characters* This field should be left blank Send Please wait...
