First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Work Phone*
x

Cell Phone*

If you are UNDER the age of 21, what is your age?

Name of pet you're interested in
Choose an animal: Blossom Buddy Coco Daisy (CL 2023) Duke (CL 2023) Gandoff Gloria June Bug (CL 2023) Kobe (2024) Maria Miss Kotty Nebula (2023) Pip (CL 2024) Rex (2023) Samson (CL 2023) Sarah (Second Chance Sarah) Sassy Spruce Stevie (CL 2023) Stripes (2023) Theresa (2023) Truffle (2023)

Cat you are interested in (if not listed above)

Why are you interested in adopting this pet?*

Have you or your family ever adopted or fostered a pet?*

Have you ever applied for or adopted a pet from Save a Stray? If yes, pet's name and when?*

Name of Person or Business that referred you to Save a Stray

Occupation and Employer of the primary financial member of the household? Who is responsible for paying? *

Years with this employer*

How long have you lived in your current home?*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal*
Choose one: Yes No N/A

Have you discussed pet deposits and policies (size, breed, etc) with your landlord?*

If you have a landlord, may we contact them? If yes, please provide name and phone number

Are you okay with a home visit from a member of our team?*

For whom are you adopting this pet*
Choose one: Self Someone Else/Gift

How many adults (over 18) are in the home?*

Ages of all household members UNDER the age of 18*

Has adopting a pet been discussed with all members of the household?*

Who will be the primary care giver?*

What is the primary caregiver's typical work schedule*

Describe your home environment (busy/lots of activity, quiet/calm, etc)*

Please tell us what role this cat will play within your family/home*

What do you expect to be the hardest part of adopting a cat and adding a pet to your home and life?*

On average, how many hours will your pet be left alone?*

Will this pet be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

When you travel, how will your pet be cared for

List pets you currently own (name, breed, and age)*

Are your current pets cat friendly?

Are your current pets altered (spayed/neutered)? If no, what is the reason they are not altered*

Are your current pets up to date on vaccinations?*
Choose one: Yes No N/A

Other than current pets, have you had any other pets in the last 10 years? If so, please share where they are now. If they are deceased, what was the cause of their passing?*

Current or Prior Veterinarian's Name and Phone Number (to be used as a reference, PLEASE contact them to allow information to be given to us)*

Name of the person the vet records are listed under?*

List TWO personal references - Family Members NOT living with you or Friends that you've known 2+ years (Name, Phone, and Email)*