Cat Haven, Inc. Adoption Application
 If you would like a printable
application that you can fill out
by hand, please click here
1. Name:
2. Street Address:
3. City:
4. State:
5. Zip Code:
6. Home Phone:
7. Work/Cell Phone:
8. Email:
9. Personal Reference:
9a. Reference Phone #:
9b. Relationship to Ref.:
10.  Are you 21 years or older?
11.  Are you interested in a cat/kitten or a specific pet (type name)?
12.  What do you know about Feline Leukemia and Feline Immunodeficiency Virus?
To ensure that this adoption is in the best interest of both you and the pet
you selected, we ask that you answer the following questions:
13. Have you ever had a cat/kitten before?
14. Please tell us why you would like to adopt a cat:
15.  Do you live in:
16.  Do you:
16a. Landlord name and phone #:
17. Are you planning to move in the next 6 months?
18. I am adopting this animal for:
19. Please list all the HUMANS your new companion will be living with:
Please list the name of each person, their age, and their relationship to you:
Human #1:
Human #2
Human #3:
Human #4
Human #5:
Human #6
20.  Does the whole family agree to the adoption of the cat a this time?
Other:
21.  Are there any CHILDREN that visit your home frequently?
Ages:
22.  Are there any regular visitors, HUMAN or ANIMAL, with which your new
companion must get along?
Describe:
23.  Is any member of your household allergic to cats?
If yes, who?:
24. What will happen to this cat if you move unexpectedly?
25. How many hours in the average workday will your cat spend without a human?
hours
26. What kind of behavior from the cat do you find unacceptable?
27.  Have you ever declawed a cat in the past?
28.  Do you plan to declaw this cat?
29. Under what conditions would you declaw?
30. What will happen to this cat when you go on vacation?
31. What will happen to this cat in case of an emergency?
32.  Do you have a regular veterinarian?
 If yes:
Veterinarian's Name:
Veterinarian's Clinic's Name
Veterinarian's Address:
Veterinarian's Telephone #:
33.  Do you currently have any other pets?
 If yes:
Pet 1 Species, Breed, Sex:
Pet 1 Neutered/Spayed?  Declawed?
Pet 1 Lives inside, outside, or both?
Pet 1 Owned for how long?
Pet 1 Where did you get this pet?
Pet 2 Species, Breed, Sex:
Pet 2 Neutered/Spayed?  Declawed?
Pet 2 Lives inside, outside, or both?
Pet 2 Owned for how long?
Pet 2 Where did you get this pet?
Pet 3 Species, Breed, Sex:
Pet 3 Neutered/Spayed?  Declawed?
Pet 3 Lives inside, outside, or both?
Pet 3 Owned for how long?
Pet 3 Where did you get this pet?
34.  Have you had any pets in the past?
 If yes:
Pet 1 Species, Breed, Sex:
Pet 1 Neutered/Spayed?  Declawed?
Pet 1 Lives inside, outside, or both?
Pet 1 Owned for how long?
35.  Do you want this animal to be:
36.  Where will this cat be kept during the day:
37.  Where will this cat be kept during the night:
38.  Where will this cat be kept when you're not home?
39.  Does your home have a pet door?
 If yes:
Where does it lead to?
We reserve the right to refuse an adoption!

Thank you for completing the adoption application.  By clicking "submit"
below, I certify that the above information is true and understand that false
information will result in nullifying this adoption