ABOUT YOU

Home Phone:      Work/Cell Phone: 

 Name, phone number, and e-mail address of nearest relative (needed for file should application be approved):
 

Note: Submitting this questionnaire is not a guarantee of adoption. Our first responsibility is to the cat/kitten and to ensuring a permanent, life-long match. For this reason, we reserve the right to decline any adoption. Regretfully, due to the high volume of applications and limited number of volunteers, we will only be calling back those applicants that are approved. You must be at least 21 years old to adopt a pet from us. Thank you.

Name of cat/kitten you are interested in:

Reason for adopting:  Family companion  For my children/spouse Companion for pet Gift
Replace lost Other 

Who will be the primary caregiver for this cat? Yourself  Spouse  Child(ren)
Other

Lifestyle:  Very active Active  Some Activity  Rather Quiet

Children:  I have children, ages of children: 
I do not have children    Children visit my home, ages:

Cat Experience:  First time cat owner  Have had a cat in the past
Currently have a cat: Age and sex
A. If you currently have a cat is the cat an indoor or outdoor cat? Please explain:

B. Is your current cat(s) spayed/neutered?Yes No    Declawed/Tendonectomy? Yes No  
C. If you had a cat but no longer have your pet, what happened to it and when?

D. Any other pets in the home? (Please specify  breed, sex, and age and if they are spayed/neutered)

The characteristics I am looking for in a cat are (check all that apply):Active/playful Calm Declawed
Lap cat Affectionate  Loves to cuddle 

Are you aware of the dangers of coyotes and other wildlife in this area?  Yes No

How many hours per day will the cat be left alone? 

My cat will spend its time: Inside only Outside only Have supervised outside playtime (includes patio/balcony) Outside during the day, inside at night  Outdoor and garage only Other

What type of outdoor access, if any, will the cat have?
Is there access to a patio, balcony, or backyard?

Is anyone in the household allergic to cats?  Yes No  
If yes, how are the allergies being managed?

How do you intend to deal with issues regarding cats clawing furniture, digging potted plants, etc?Trim/Clip nails Declaw/tendonectomy Buy scratching post Other

Do you have a doggie door? Yes No   If yes, where does it lead to? 

Your living situation?  House Condo/Townhouse   Apartment Mobile Home

Who owns your home? I own I rent   I Lease Live with parents Live with roommates
How long at current address:

If renting or leasing, do you have your landlord's permission to have pets?  Yes No
Please provide the name and phone number of your landlord: 

If renting/leasing, does your landlord require that cats be declawed? Yes No
If renting/leasing, are you willing to pay any required pet deposits?Yes No
(Your landlord information must be provided and they will be contacted for verification)

What kind of behaviors do you feel you cannot accept?

Under what circumstances would you not be able to keep this pet?  (Please check all that apply):
Pregnancy/baby Divorce/separation Requires daily treatment Needs too much attention
Job change/loss New house/apartment Scratches carpet/furniture Behavioral problems
Expensive vet bills Conflict w/ other pets Sprays/litterbox issues Needs special diet
Cat becomes sick/disabled Other

Who will care for the cat while you are traveling or out of town? Boarding Family member
Pet sitter Other:  

What will happen to the cat if:
You move somewhere that does not allow pets?

Get married and spouse does not want cat or has allergies?

Have a baby or child develops allergies?

You move locally or out of state?

Do you currently have a veterinarian?Yes No 
If yes, name and phone number: 
(Your vet will be contacted as a reference as part of the application approval process)

Are you willing to provide regular vaccinations, routine vet care, and proper veterinary care if this pet becomes sick or injured? Yes No 

I acknowledge that I have answered all these questions truthfully. If my application is approved, New Beginnings may conduct a home check prior to adoption and I will be required to sign an adoption contract with New Beginnings.  Yes No