Name: Daytime phone: Evening phone: Address: Cell phone: City: State: Zip Code: E-Mail address: Age of applicant Your occupation: Employer: Spouse's occupation: Employer: Applicant's VA driver's license number: To ensure this pet adoption is in the best interest of you and the animal you select, please answer the following questions: List all members of your household: Name 1: Age: Name 2: Age: Name 3: Age: Name 4: Age: Name 5: Age: Pet Ownership History: :Please list all of your pets, including pets still with you and those you no longer have: (Type (Dog/Cat) Breed Age Gender Spayed/Neutered? How long owned? Still own? If no, why?) Do you have a regular veterinarian? Yes No Name of your veterinarian Veterinary hospital: Hospital address: Phone Number: Do you live in Apartment Condo Duplex House Other Do you: Own Rent Are there any pet restrictions? If renting, landlord's name: Landlord's phone number: How long at current address? Are you planning on moving in the next 6 months? Yes No Are you adopting this pet for: Yourself Children Gift Other: If other please explain. Who will be primarily responsible for the care and supervision of this cat? Are there any children not listed above who visit frequently? Yes No Ages: Do you live with: Parents Spouse Roommate(s) Alone Other If other please describe condition. Have you ever had to give up or re-home an animal? Yes No If so, please describe the circumstances:
Are there any major changes planned for your family in the next year? Yes No If yes please describe. Do any members of your household have known allergies to cats? Yes No Some behaviors might occur after you bring your new cat home. How are you planning to handle this? Who will care for this cat when you go on vacation or should an emergency arise? Are you aware that the average annual veterinary expense for a cat is between $100-$300? Yes No Are you prepared for this type of expense or an emergency veterinary expense? Yes No How many hours during the average day will this cat spend without a human? Where will this cat be kept when you are at home? Where will this cat be kept when left alone? Do you plan for the cat to use: Litterbox Outdoors Both Have you owned a declawed cat in the past? Yes No Are you considering declawing this cat? Yes No Maybe
By submitting this form I assume all risks of ownership of this cat, including any and all liability for damage or injury caused by or to the cat. I give my permission to Somebuddies, Inc. to contact my veterinarian to obtain information concerning past and present pets and to contact any other references I have provided. I certify that the information I have given is true and accurate, and that I recognize that any misrepresentations of facts may result in my losing the privilege of adopting a cat. I understand that Somebuddies Inc. has the right to deny my request to adopt a cat and I authorize investigation of all statements in this contract and the related adoption application both before and after the adoption. I agree to allow a Somebuddies, Inc. representative, with reasonable notice to inspect the cat and it's living condition before and/or after the cat's adoption.
Somebuddies, Inc. reserves the right to refuse an adoption for any reason. Somebuddies, Inc. P. O. Box 1532 Mechanicsville, VA. 23116 Phone (804)-559-6170 www.somebuddiesinc.com