First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Work Phone
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Cell Phone*

Alt Email

Which animal are you interested in
Choose an animal: Aiden Bali Bruce Bubbles Claudius Kovu Nero Otto Pumbaa Rafiki Remy Scar Shasta Timone

How did you find out about us? If referred by a foster/volunteer or previous adopter, who?

Why are you interested in adopting a pet at this time*

Veterinarian's Name and Phone Number*

Including yourself, how many people live in the home and what are their ages?*

In the event of an emergency that leaves you unable to care for your cat, who will provide for them?*

What is your current place of employment or source of income to care for the cat?*

How many animals do you currently have, and what kinds? Are they up to date on their shots, are they Neutered/Spayed? *

Will the animal be indoor only or let outside? If outside, please explain?*

How much time will the animal spend alone during the day*

Are you planning to Declaw(surgical procedure that permanently removes the distal phalanx, last bone, of each toe)? If yes, why? *

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

Have you ever given up a pet? If yes, please explain*

Does your home have a doggie door? *Doggie door that leads to outside**
Choose one: Yes No

I certify that the information entered on this application is true. Enter your name and date*