FELINE ADOPTION APPLICATION

Name:_____________________________________________   Date:___________________

Address:___________________________________________        Phone:  Home____________              

                                                                                                                           Work ___________

E-Mail:_______________________________________Driver's License #: ____________________

I certify the following information is true and I understand that false information will nullify this adoption application. I also authorize my veterinarian to discuss with GHSI any or all records pertaining to my past and present pet(s).

Veterinarian Name: ________________________________________________ Phone: ______________

Address: ______________________________________________________________________________

Do you live in a [ ] House     [ ] Condo     [ ] Apartment     [ ] Mobile Home?   How long? _____________

Do you                   [ ] Own       [ ] Rent ?        Name of Landlord ___________________ Phone: __________

Have you applied to adopt an animal from us before?                                            [ ] Yes                   [ ] No
Have you ever brought an animal to a shelter?                                                       [ ]Yes                   [ ] No

If so, circumstances: _____________________________________________________________

If your animal gets lost, what will you do to find her/him? ____________________________________
Do you plan to neuter your animal? [ ] Yes    [ ] No  Why or why not? ______________________

Do all family members favor this animal?                                                                [ ] Yes                  [ ] No
Which member of your household will be responsible for the feeding

and training of this animal? _______________________________________________________
Are there any family members allergic to animals?                                               [ ] Yes                   [ ] No
Are there young children in the home?                                                                    [ ] Yes                   [ ]No
What other animals are currently in your home? ___________________________________
If you currently own no pets, what pets have you had in the past? [ ] Yes   [ ] No

What happened to them?__________________________________________________

How much time will you allow your new animal to adapt to your preset pet(s) and new home? _________
How many hours a day will this animal be left alone? _________________________________
Do you plan to keep this animal [ ] Indoors     [ ] Outdoors?

If outdoors, how busy is your street, traffic wise? _____________________________

If outdoors, what kind of shelter will be provided? ____________________________

Do you plan to declaw this animal?                                                                           [ ] Yes                  [ ] No
If yes, reason: _________________________________________________

Do you intend to put identification on your cat? If so, what type? ____________________________

Cats can live more than 15 yrs. Are you ready to assume responsibility for his/her entire life? [ ] Yes  [ ]No              

New York Slate law now requires rabies vaccine. In addition, cats need other inoculations.

Will your make sure your cat gets these shots?    [ ] Yes         [ ] No

Why do you want to adopt a cat? _________________________________________________

Describe the perfect cat for you. ___ _______________________________________________

What type of cat behavior would you find difficult to deal with? ____________________________

What would you do with this cat if it lost a limb, went blind or deaf, or developed some other physical disability? ___________________________________________________________________________

What will you do with this cat when it becomes elderly? _____________________________________

Are you prepared to commit quality time, money and effort to the care training and adjustment of this cat?

[]Yes                   []No
What would you do if your present pet(s) did not gel along with the new cat? ____________________

What would you do with your pets if you moved? ___________________________________________

Do you object to a home visit or phone calls from a GHSI Representative?   [ ] Yes          [ ] No

GOSHEN HUMANE SOCIETY, INC.    PO Box 37   Goshen NY 10924     (845) 294-3984