Cat Adoption Application Form Page 2
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1
2If you presently have DOGS, please complete:
Spayed/
Current on
Dog’s Name
Breed
Age
Gender
neutered?
vaccines?
If you have previously had companion animals, please complete:
Name
Breed
Years owned
What happened?
Name of your veterinarian______________________________________________City/Town_______________________________
Have you ever turned a pet into a shelter? _________If yes, explain____________________________________________________
When you go on vacation/travel, who will care for the cat? __________________________________________________________
How much are you willing to spend on medical bills for your cat? ____________ What would you do if the bills go over this amount?
_________________________________________________________________________________________________________
Are you ready to take responsibility for this cat for the next 15-20 years? __________________________________________
What provisions will you make for the cat should you become unable to care for it ?_______________________________________
Have you previously applied to adopt a dog or cat from LDCRF? ________If yes, when?__________ Explain:___________________
Have you ever relinquished or returned a dog or cat to LDCRF? ____ If yes, when? ___________ Explain:______________________
Are you willing to have a representative of LDCRF visit where the cat will be living?__________
I certify that the information above is true and understand that false information will result in nullification of this adoption.
Prospective Adopter Signature:________________________________________________________________Date:____________
INTERVIEWERS, Please initial that you have discussed the following topics: flea/tick prevention vaccines
exercise needs
return policy
fees
medical records/ future expenses
litterbox issues
scratching needs
Interviewer Approval:________________________________________________________________________Date:____________
Interviewer Approval:________________________________________________________________________Date:____________
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