Lost Paws Animal Rescue Adoption Application

Name  Home Phone
Street  Work Phone
City   Cell Phone
State, Zip  Email Address

How Long at Current Address
_ Over 3 Years 2 Years 1 Year 6 Months

Cats or Kittens Interested in Today


How Many Adults in the Home
_ 1 2 3 4 Over 5

How Many Children in the Home
_ None 1 2 3 4 Over 5

What are their ages?



Don't see anyone who catches your eye?
Tell us what you are looking for and we
can match you with the perfect companion

Age
_ Any Kitten Adult Senior

Gender
_ Any Male Female

Other Requirements
Already Declawed
Barn Only
Color



Would you prefer that this cat gets along with:
Other Cats
Dogs
Children
Other Pets


Will this cat be:
Declawed
Outside Supervised
Strictly Indoors
Strictly Outdoors
Outside on Leash

Please List Pets you Currently Own:
Pet's Name	Dog or Cat	Fixed	Declawed
_ Dog Cat _ Yes No _ Yes No
_ Dog Cat _ Yes No _ Yes No
_ Dog Cat _ Yes No _ Yes No

Please List Pets you Previously Owned:
Pet's Name	Dog or Cat	Fixed	Where is this pet now
_ Dog Cat _ Yes No
_ Dog Cat _ Yes No
_ Dog Cat _ Yes No

How Many Cats Live in Your Home Now?
_ None 1 2 3 4 5 or More


How Many Dogs Live in Your Home Now?
_ None 1 2 3 4 5 or More

What Vet do you use for your current pets?

Street  City  Phone #

What Vet did you use for your previous pets?

May we call your current and previous Vets for a reference?   _ Yes No

Residence:   _ Single Family Home Multi Family Home Condo Townhouse Apartment  You Currently:   _ Own Rent Lease Live with Parents

If you rent/lease, do you have permission from your landlord to have a cat?   _ Yes No

Landlord's Name    Phone #

Lost Paws may require a copy of your lease before adoption.

Who will be taking major responsibility for this pet?  

Are you willing to let a Lost Paws Rep periodically visit your home?   _ Yes No

Should your cat become ill and require costly medical services, will you allocate sufficient resources for healthcare to preserve his/her life?   _ Yes No

I certify that all the above statements are true:
    Date:

Lost Paws Reserves the Right to Refuse Any Application.