Your occupation:
Work hours:
Number of persons in household:
Number of children:
Ages of children:
Name of spouse or roommate:
Occupation of Spouse or Roommate:
How long at present address? (specify years or months)
Do you rent or own?
Rent
Own
Landlord's Name
Landlord's Phone
No.
Type of residence:
House
Condo
Apt.
Mobil Home
Townhouse
Other
When would the
cat be inside?
Please Choose
All the Time
At Night
In & Out
Never
Other (specify below)
If other, please specify:
When would the
cat be outside?
Please Choose
All the time
In & Out
Never
Other (specify below)
If other, please specify:
In what areas would the
cat be allowed?
What
rooms are off limits to the cat?
Where do you plan to put the litter box?
How many hours of the day would the
cat be alone?
Do all of your windows have screens and are
in good condition?
Explain:
Where
would the cat sleep at night?
Do you plan to declaw your cat?
Please Choose
Yes
No
Have you declawed a cat in the past?
Please Choose
Yes
No
If so, why?
Who
is the pet for?
Self
Child
Family
Gift
Other (specify below)
If
other, please specify:
Who
will be responsible for taking care of the cat?
Self
Spouse
Child
Roommate
Is anyone in your household allergic to
cats?
Please Choose
Yes
No
Why
do you want a cat? (choose all that
apply)
How do you plan to provide for the
cat when you are out of town?
What would you do if you had to move and had trouble finding a place
that allowed pets?
What would happen to the
cat if you had to relocate out of state or
overseas?
If the cat claws your furniture or carpet,
what would you do?
What would you do if the undesirable behavior continued?
Under what circumstances would you not keep the
cat?
What would you do in that event?
Are
you willing to live with an animal that be destructive at times?
Please Choose
Yes
No
How
would you rate your cat experience?
What would you do if you or your spouse
became pregnant?
Do you feel a cat should wear a collar and
i.d. tag, even if it's in indoor only cat?
Please Choose
Yes
No
Which
of the following reasons might prompt you to give up your pet?
Are
you prepared for veterinary expenses such as emergency medical problems
(especially in old age), that you will incur when adopting this cat for
its entire life?
Please Choose
Yes
Not Sure
No
Existing
and Previous Pet Ownership Information:
Please indicate all dogs and cats you have owned, and all pets you
currently have. Under the column "What Happened" explain if the pet was
lost, given away, stolen, sold, taken to an animal shelter, or died (in which case state
cause of death).
Type of Pet:
None
Dog
Cat
Bird
Horse
Other
Sex:
How
& Why Obtained:
How Long Owned: (specify
years or months)
What Happened?
Type of Pet
None
Dog
Cat
Bird
Horse
Other
Sex:
How & Why Obtained:
How Long Owned: (specify
years or months)
What Happened?
Type of Pet
None
Dog
Cat
Bird
Horse
Other
Sex:
How & Why Obtained:
How Long Owned: (specify
years or months)
What Happened?
Have you ever bred a
cat?
Please Choose
Yes
No
If yes, why?
If you presently own a dog or cat, is it spayed or neutered?
Please Choose
Yes
No
If not, please explain why:
Do you have a veterinarian?
Name and City of vet:
Would you agree to an inspection of your premises by New Leash On
Life?
Why do you want this
cat?
Is there any other pertinent information you would like us to know?
