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Adoption Application

Have you read about how to adopt a cat or kitten from Homeless Kitties?
(Required form fields are in bold.)

Homeless Kitties is committed to placing homeless cats and kittens in homes compatible with your and the animal’s needs. Please answer all questions to assist us in our match. Your application will be reviewed by our Adoption Committee.
Cat
Benny
Name: Benny Description: Male, Domestic Short Hair, Tabby with white
New Home
Name:
First:   Last: 
Address:
City: State: Zip:
Home phone:
Work phone:
Cell phone:
E-mail:
Current employer?  Position?  Time on the job?
Is your home a House, Townhouse, Condominium or an Apartment?
How long have you been at this address?
Do you own or rent your home? Own Rent
How heavy is the traffic on this street? Light Medium Heavy
Do your windows have screens? Yes No
Environment
How many adults in the home? How many children? Ages of children?
Does anyone in the home have allergies to cats? Yes No
What pets do you currently have? Please include their ages and how long you have had them.
If you already have a cat, is he/she Indoor only Outdoor only Indoor/Outdoor N/A
Benny will be Indoor only Outdoor only Indoor/Outdoor
How many hours a day will Benny be alone?
Where will Benny be when alone?
Where will Benny be when you are at home during the day?
Where will Benny be when you are at home at night?
Where do your current pets (if any) sleep?
Where will Benny sleep?
Will Benny be declawed? Yes No
Pet Care
Who provides veterinary care for your pets? Phone:
Who will be primary caretaker for Benny?
How often does the primary caretaker travel?
Who will take care of Benny in an emergency or during vacations?
What will you do with Benny if you have to move?
Experience
What pets have you had previously? Please include their ages and how long you had them.
What happened to them?
Have you ever lost a pet or had one run away? Yes No
Have you ever had a pet hit by a car? Yes No
Have you ever had a declawed cat? Yes No
Have you ever surrendered a pet to a shelter? Yes No
Have you ever nursed a sick animal? Yes No
Comments
Is there anything else you want to tell us about yourself or the place Benny will be living?
Signature
I certify that the above information is true and understand that misrepresentations may result in the cancellation of the adoption. In providing a veterinarian reference, I am authorizing the veterinarian to disclose information to HK.
Feedback
Have you attended a Homeless Kitties Adoption Fair? Yes No
Security code:
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