Name of Cat:
*
To adopt, you must check that you agree to all of the below:
Your Name:
*
First Name
Last Name
Your date of birth:
*
MM
DD
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Name of Spouse, Partner, or Roommate:
First Name
Last Name
Your Address:
*
Tip: This is a system generated form, it has a bug in that it requires the "Address 2" field to be populated with something and not everyone has an Address 2. Please enter a "-" (dash) in Address 2 area if you do not have an Address 2.
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Home Phone:
(###)
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Work Phone:
(###)
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Mobile Phone:
(###)
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Email Address:
*
Your Place of Employment:
*
Applicants Work Hours (Closest to option(s)) *
Applicant other work hours (please describe)
Spouse/partner’s place of employment:
Spouse/Roomate/Partner Working Hours
S/P/R other work hours (please describe)
How many adults are in your home?
*
How many children are in your home?
*
If you have children in the home what are their age(s)?
How does your spouse/partner feel about adopting this cat?
Is any household member allergic to animals?
*
If yes to allergies, how will you deal with reactions to this pet?
Do you have any dogs?
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If yes, how many dogs are in the house?
Have the dog(s) lived with a cat before?
Where did you hear about OPIN and the pet or adoption?
*
Why do you want to adopt a cat/kitten?
Why did you choose this particular breed/mix of cat?
Will the adopted cat be:
Have you ever owned a cat?
If 'yes' do you still have it?
If no longer have a cat, what happened to the cat?
Have you ever given a pet to a shelter or to someone else?
*
If yes, please explain:
Have you ever had a pet euthanized?
*
If yes, please explain:
Have you ever owned a declawed cat, or had a cat declawed?
If yes, give the reason:
Would you ever declaw the cat/kitten you want to adopt (if not declawed upon adoption)?
*
If yes, under what circumstances?
Have you ever been investigated for animal neglect or cruelty?
If yes, why?
Are you familiar with local animal control laws?
*
Are you FINANCIALLY ABLE to spend this kind of money on this cat if required?
*
Are you COMMITTED to spend this kind of money on this cat if required?
*
Cats can live 15 years or longer. Can you commit to caring for this pet for that long?
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Will you give all required medical care necessary for the life time of this pet?
What provisions will you make for the cat should you become unable to care for him/her?
Under what circumstances would you give up the cat?
What will you do with the cat if you have to move?
What will you do with the cat if you have a baby?
Will you work out bad habits (scratching, biting, house-soiling, etc.) the cat may have?
If yes, how are you planning on dealing with any bad habit?
If you go away for a few days, or on a vacation, who will take care of the cat?
Are you willing to take responsibility for this cat for the next 15 years or more?
*
If no, explain:
Do you own or rent your home?
How long have you lived at your current address?
Do you live in a:
*
If other please explain:
Landlord Name:
First Name
Last Name
Landlord Phone:
(###)
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Personal Reference 1:
*
First Name
Last Name
Personal Reference 1 Phone:
(###)
###
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Personal Reference 2:
*
First Name
Last Name
Personal Reference 2 Phone:
(###)
###
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Name of your PRESENT Veterinarian & Hospital:
City and phone number (Present Vet):
Name your pet records are under at your present vet (if different than applicant):
Name of your FORMER Veterinarian & Hospital:
City and phone number (Former Vet):
Name your pet records are under at your former vet (if different than applicant):
Give us information about all the animals alive and currently living in your household:
*
Name of Pet Dog/Cat/ Other, Breed, Sex, Spayed / Neutered? Age, Weight, Vaccinated? Dog licensed?
Give us information about the last 3 animals that you no longer have (deceased or otherwise):
*
Name of Pet Dog/Cat/Other, Breed, Sex, What happened to pet? If dead, how did it die? If dead, age at death, Date of death or surrender
Additional comments from applicant:
Your Signature
*
Enter your name.
First Name
Last Name
Today's Date
*
Enter today's date.
MM
DD
YYYY
Final comments:
For OPIN Use Only
Status:
For OPIN Use Only
Date of Decision:
For OPIN use only. Applicants please click the submit button.
MM
DD
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