Thank you for considering the adoption of one of
our cats to become a companion and member of your family.
Please note: our primary adoption efforts are focused in Montgomery and
Bucks counties (Pennsylvania), but we will occasionally and on a
case-by-case basis, make placements in Chester, Delaware and
(Please note that if you have any technical problems with this form, that you can click here to open a Word document version of this form. You can complete the form,
save it, and then send it as an attachment to firstname.lastname@example.org)
Home Phone: Work
City: State: Zip:
Type of cat(s) you are interested in:
Name of cat(s) you are interested in:
1. Why do you want to adopt a pet?
2. What do you think are the most important responsibilities in
owning a pet?
3. For whom are you adopting the pet?
4. Have you ever owned a pet before?Yes No
a. Please describe those pets that are currently with you (type,
age, sex, altered status).
b. Please describe those pets that are no longer with you (type,
age, sex, altered status)
c. What happened to the pets who are no longer with you?
5. Please provide the name and phone number of the veterinarian
for your pets.
6. How many people reside in your household?
7. Are there any children in the household? Yes No. If yes, what are their ages?
8. Does anyone have allergies to pets?Yes No.
9. Who will be responsible for the care of your pet?
10. Do you own or
rent your residence?
11. If you rent, please provide the name and phone number of your
12. Where will your pet be kept?inside outside both
13. Do you intend to declaw your cat?Yes No.
14. When on an extended trip, what do you plan for your cat's
15. How did you hear about Stray Cat Blues?
1. Name: Phone:
By submitting this form I represent that the information that I
have provided is the truth to the best of my knowledge and belief.