Adoption Application

Peninsula CatWorks 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.

New Home

Name:
First: Last:
Address: 
 
City:
State:
Zip:
Home phone:
Work phone:
Cell phone:
E-mail:
How long have you been at this address?
Do you own or rent your home? Own Rent
Landlord's name:  Landlord's phone: 
Pets allowed? Yes No
How heavy is 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.
How many hours a day will the cat(s) be alone?
Where will the cat(s) be when alone?
Where will the cat(s) be when you are at home during the day?
Where will the cat(s) be when you are home at night?

Pet Care

Who provides veterinary care for your pets? Phone:
Who will be primary caretaker for the cat(s)?
How often does the primary caretaker travel?
Who will take care of the cat(s) in an emergency or during vacations?

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? 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
  Please explain why you surrendered the pet.
 
Have you ever nursed a sick animal? Yes No
  Please describe the illness and the care provided.
 

Comments

Is there anything else you want to tell us?

Feedback

Have you attended a Peninsula CatWorks Adoption Fair? Yes No

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 PCW.