HELPING PAWS CAT ADOPTION APPLICATION

Helping Paws Staff Only

Which cat are you interested in adopting?

Name

First Name

Last Name

Home or Cell Phone Number

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicant Occupation

Applicant Work Phone Number

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Applicant Age

Co-Applicant Name (if applicable)

First Name

Last Name

Co-Applicant Home or Cell Phone Number

(###)

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Co-Applicant Email

Co-Applicant Occupation

Co-Applicant Age

How long have you lived at your current address?

What type of home do you live in?

Rent or Own?

Landlord's Name and Phone Number (if renting)

Who else lives in your home with you?

Exact ages of children in the home (if any)

Please list ALL the pets you have had in the past 5 years with name, breed, and age (if none, type NONE)

Are all current pets spayed/neutered and up to date on vaccines?

Do you plan to declaw the cat?

Do you agree to provide regular veterinary care by a licensed veterinarian??

What type of living situation will best describe what you are looking for in a cat?

Do you agree to contact HELPING PAWS, INC. if you can longer keep this cat?

Have you owned cats before?

What brand of food are you using or planning on using?

How did you hear about this cat?

If you heard from a friend, please list their name below

Who is your current veterinarian and what is their contact information? (If none, type NONE)

Please provide a reference you is NOT a family member:

Reference #1 Phone Number

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Please provide a reference who is NOT a family member:

Reference #2 Phone Number

(###)

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By submitting this application, I certify the information provided is complete and correct to the best of my knowledge. I give my permission for any of this information to be verified. Additionally, I give permission for my name, address, and email address to be collected. This information is used to communicate with you regarding our organization. Your information will never be shared or sold. I understand HELPING PAWS, INC. has the right to deny any application.