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CAT ADOPTION APPLICATION

NAME: ____________________________________________ DRIVERS LICENSE #: _________________________________

ADDRESS: _________________________________________ CITY: ________________________ ZIP: _______________

HOME PHONE: _____________________________________ WORK/CELL PHONE: ________________________________

E-MAIL: __________________________________________________________________________ DATE: _____________

How did you hear about us? Website Facebook Friend/Family Adoption Promo Other:______________ Thank you for considering adopting a pet from our shelter! We will be happy to conduct an animal interaction if/when your application has been approved. Remember, you are potentially making a 10-20 year commitment. All cats have been vaccinated for FVRCP. Your veterinarian may recommend additional vaccinations at the adopter’s expense. Kittens often require a series of vaccinations. Cats over three months of age have been vaccinated for rabies. If your kitten is not already vaccinated for Rabies, you will be provided with a date/time to return for his/her vaccination. All cats have a microchip as a permanent form of identification, have been spayed or neutered, and tested for FIV/Feline Leukemia. Adoption fees are non-refundable. Your adopted pet must be taken to a veterinarian within 7-10 days of adoption for an exam and any necessary vaccinations/medications. You will be provided with a medical/vaccination record at the time of adoption that should be shared with your veterinarian.

PLEASE LIST ANY PETS THAT ARE CURRENTLY IN YOUR HOME:

BREED NAME AGE OWNED HOW

LONG? VETERINARY HOSPITAL

CURRENT ON VACCINES?

Yes No

Yes No

Yes No

Yes No

Yes No

PLEASE LIST ANY PETS YOU HAVE OWNED IN THE PAST 5 YEARS:

BREED NAME OWNED HOW

LONG? NOT CURRENTLY IN HOME

BECAUSE? VETERINARY HOSPITAL

STAFF ONLY Time application submitted:

I am interested in meeting:

1._____________________

2._____________________

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How many people, including yourself, are currently living in your home? ________________

Please list the names and ages of the people living your home (include last names if different from yours):

1. _____________________ Age: _____ 2. _____________________ Age: _____ 3. _____________________ Age: _____

4. _____________________ Age: _____ 5. _____________________ Age: _____ 6. _____________________ Age: _____

Do you live in a single-family home, townhouse/condo, or an apartment? _________________________________

Do you own or rent your home? ____________ Renters, provide landlord name & number __________________________

Townhome/condo association name & number _________________________________________________________

PERSONAL BACKGROUND INFORMATION:

Is anyone in your household allergic to cats? Yes No

How long have you lived at your current address? _______________________________

In the last 5 years, how many times have you moved? ____________________________

Describe the activity level in your household? _________________________________________________________________

Have you ever given a pet away or relinquished a pet to a shelter? Yes No

If yes, please explain: ______________________________________________________________________________

________________________________________________________________________________________________

MATCHING THE RIGHT PET: Why are you looking to adopt from our shelter? (Check all that apply) Adoption Promotion/ Price Variety of Animals Desire to Rescue an animal Repeat Adopter

What traits are you looking for in a cat/kitten? (Check all that apply)

Playful Independent Lap Cat Outgoing Male Female

Declawed Calm Long Hair Short Hair Low Maintenance

Other _______________________________________________________________________________________________

Why do you want to adopt this cat? (Check all that apply)

Companion Companion for another animal Gift Mouser To teach a child responsibility

What will you do with your cat if you move? __________________________________________________________________

_______________________________________________________________________________________________________

Do you plan to let the cat outside? Yes No

Who will be responsible for the cat’s daily care? _______________________________________________________________

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Where will you keep your animal when you are at home?

Bedroom Basement Garage Laundry/Utility Room Run of the House Other _______________

UNDERSTANDING CAT BEHAVIOR: * Please answer these questions to the best of your ability. Any questions you have can be discussed with an adoption counselor.

A cat may stop using the litterbox for a variety of reasons. What steps will you take in the event that your cat stops consistently using the litterbox?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Scratching is a normal behavior which cats use to stretch, shed the outer layer of their nails, and mark their territory. What will you do in the event of destructive behavior, for example, if the cat uses your furniture for a scratching post?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Like dogs, you can tell a lot about a cat’s mood by their body language. How would you respond if your cat’s tail is swishing back and forth and its ears are pinned back?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

It may take a month or longer for a cat to adjust to a new home, especially if it is an older animal or other animals are involved. How will you work with your cat during this adjustment period?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

What would be an unacceptable behavior which would cause you to give up your pet?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

CARING FOR YOUR CAT:

Do you already have a Veterinarian? Yes No

If yes, what is the name of the hospital/clinic and veterinarian? ____________________________________________

If no, what is your plan for veterinary care? ____________________________________________________________

Owning a cat means paying for food, litter, toys, treats, vet care, immunizations and more. Cats can live for 20+ years. Are you willing to budget for these expenses for the cat’s entire life? Yes No

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It is recommended that you have the same number of litter boxes plus one as there are cats in the home. Are you prepared for the daily maintenance of multiple litterboxes? Yes No

What do you plan to do with your cat when you go out of town? _________________________________________________

______________________________________________________________________________________________________

What provisions will you make for your cat if you become unable to care for them? __________________________________

______________________________________________________________________________________________________

Would you return a cat for any of the following reasons? (Check all that apply)

Allergies Marriage/Divorce Cat has medical problems

Having a baby Want a younger cat Destructive scratching

Job Change Financial problems Always hiding

Moving Cat going outside the litterbox

Other, please explain: __________________________________________________________________________________

Tell us why we should adopt a pet to you: ____________________________________________________________________

_______________________________________________________________________________________________________

Are there any topics you would like to talk about with an adoption counselor? (Check all that apply)

Feeding your pet Grooming Behavior issue What to do if your pet is lost

How a microchip works Other: ___________________________________________________________________

By signing below, I certify that I am 18 years of age or older, the information that I have provided is true and that I recognize that any misrepresentation of facts may result in my losing the privilege of adopting a pet. I authorize DuPage County Animal Services to investigate all statements made in this application. I also understand that adoption may be refused at the discretion of the DuPage County Animal Services staff.

SIGNATURE: ________________________________________________ DATE: ____________________

Staff Notes:

I have interacted with (staff only):

Animals Name: ___________________________ Date of interaction: ________________________

Animals Name: ___________________________ Date of interaction: ________________________

Animals Name: ___________________________ Date of interaction: ________________________