Name:
Street Address:
City, State, Zip:
E-Mail Address:
Home Phone with Area Code:
Cell Phone with Area Code:
Date of Birth:

Information about the animal you wish to adopt:

Name of Animal:
Who will be responsible for this pet?
Where will the cat be kept during the day?
Where will the cat be kept in the evening?
Where will your cat sleep at night?
Will your cat be allowed outside?:
yes.
no.
Do you want to have your cat declawed?:
yes.
no.
If yes?:
2-paw
4-paw

If yes, why?

Information about your current residence:

Do you own or rent?
If you rent, landlord's name:
Landlord's phone number?
Residence type:
House
Apartment
Mobile home
Farm
How many members in the household?
Are there children in the household?
If yes, how many?
Their ages:
Does anyone in the household have asthma or pet allergies?
Have you or anyone in the household ever been convicted of an animal related crime?
Does anyone that lives in the household smoke?

Pets:

Do you currently have any pets?
Are they spayed/neutered?
Please list the breed, age, and sex of current pets:
Have you had pets in the past? If yes, please list types and what happened to them:

Information about your veterinarian:

Name of veterinarian:
Address:
Phone:
Will you use this vet for your new pet?
Yes
No
If not, who will you use?
Phone:
May we have permission to contact your veterinarian?
Yes
No

Other:

Cats often live longer than 15 years. Are you prepared to take responsibility for this pet for its entire lifetime?
Yes
No
It may take your pet a month or longer to adjust to a new home. Are you willing to allow this much time for adjustment?
Yes
No
Are you willing to allow your pets time to adjust to each other?
Yes
No
Are you adopting this pet as a gift for someone?
Yes
No
If yes, does the recipient know about it?
Yes
No
Do you agree to return the pet to Pet Angel in the event that you can no longer keep it?
Yes
No
Are you willing to let a representative of Pet Angel visit your home by appointment?
Yes
No
Have you ever adopted from a humane organization in the past?
Yes
No
If yes, name of the shelter or organization:
Have you ever released an animal to any shelter?
Yes
No
If yes, please explain:

Please provide the names and phone numbers of two pet friendly references (neighbors, friends, etc.) Relatives may not be references.

Reference one:

Name:
Relationship to applicant:
If yes, please explain:
City and State:
Day phone number:
Evening phone number:
E-mail address:

Reference two:

Name:
Relationship to applicant:
If yes, please explain:
City and State:
Day phone number:
Evening phone number:
E-mail address:
By submitting this application, I certify that the information provided on this application is true, and I recognize that any misrepresentation of facts may result in losing adoption privileges. I authorize investigation of all statements in this application and understand that veterinarians, landlords, other human organizations, references, etc. may be contacted. I further understand that the adoption of the animal may be delayed until this information can be verified. If at any time a representative from Pet Angel Adoption & Rescue Inc. and/or other local authorities determine the animal is being neglected or abused, this application will be void and ownership will revert back to Pet Angel Adoption & Rescue Inc.