Cat Adoption Application Please enable JavaScript in your browser to complete this form.Name of animal you are interested in: *Name *FirstLastAddress *City *State *Zip *Home Phone *Work PhoneCell PhoneEmail *Employer *What is your current age? *When was the last time you owned a pet? *Why don't you own that pet currently? *Will this be your first cat? *YesNoPlease list the pets you have had in the past 5 years:Please include Name, Age, Breed, Sex, If Neutered, Still Have?, if No, Why?Pets Owned 2Please include Name, Age, Breed, Sex, If Neutered, Still Have?, if No, Why?Pets Owned 3Please include Name, Age, Breed, Sex, If Neutered, Still Have?, if No, Why?Pets Owned 4Please include Name, Age, Breed, Sex, If Neutered, Still Have?, if No, Why?Please provide your veterinarian’s name, address and phone number (if known): *Have they been spayed or neutered? *YesNoI don't knowAre they current on vaccinations? *YesNoI don't knowWill you keep this cat up to date on vaccinations? *YesNoHave your cats been tested for feline leukemia? *YesNoI don't knowHave they been tested for FIV? *YesNoI don't knowAre they declawed? *YesNoI don't knowIf yes, where is the cat declawed?Front pawsAll four pawsWhat type of cat behavior would you have the most difficulty in dealing with for any length of time?What would you do to handle this situation? Please explain:Have you ever turned your cat in to a shelter?YesNoIf 'Yes', please explain:Have you ever had a pet euthanized for medical reasons?YesNoIf 'Yes', please explain: (copy)If you have pets, will they adjust to a new cat entering the house? *YesNoI don't knowWhat would you do if the present cat or dog does not get along with the new cat?How much time would you give the adjustment period?Why do you want this cat?CompanionCompanion for other petGiftOther - please explain:Does everyone living in your home know about and agree with your decision to adopt a cat?YesNoIf not, why?How many adults are in your household?What are the adults' ages and relationships to you?How many children?Please indicate ages of children.Does any member of your household have an allergy to cats?YesNoIs someone home during the day?YesNoIf yes, who?How many hours each day will the cat be alone?Please provide details.Where do you live?HouseApartmentCondoMobile HomeOtherIf other, please explain:Do you own or rent your home?OwnRentIf you own, who is the owner on record?If you rent, may we contact the owner to obtain permission for this cat to live in your home?YesNoOwner's name and phone number:Where will you keep the cat? *In the houseOutdoorsFree access both indoors and outdoorsIn the barnOtherIf other, please explain:Do you have a cat or dog door? *YesNoWill you have the cat declawed? *YesNoMaybeAre you aware of the potential side effects of declawing? *YesNoIf you go away for a few days, or on a vacation, who will take care of the cat? *If you move, will you take the cat with you? *YesNoHave you ever applied to Middletown Humane to adopt an animal? *YesNoIf yes, when?Have you ever brought animals to Middletown Humane? *YesNoIf yes, please explain:Are you willing to have a representative of Middletown Humane come to see where the cat will be living? *YesNoIf no, please explain:Are you willing to take responsibility of this cat for the next 10 to 20 years? *YesNoWhat provisions will you make for the cat should you become unable to care for him/her? *What behavior will you have the most difficulty dealing with? *What would you do if your cat exhibited bad behavior you didn't like? Such as chewed on your valuable items, hard to fully potty train, jumping on people, mouthing humans, hurt another pet, bite someone. *Do we have your permission to view your social media accounts? *YesNoHow much are you willing to spend on medical bills for your cat? *Up to $100Up to $500Up to $1,000Up to $5,000Whatever it takesWhat would you do if the vet bills went over this amount? *Additional comments:Please provide two personal references (no relatives): *Phone *Ref #2 *Ref Phone #2 *Please read the following and check the box to complete the application. *I certify the above information is true. I understand that giving false information on the application is grounds for denial of application and repossessing the dog if the application is approved. I understand the Middletown Humane Society reserves the right to deny any application.Submit
