Friends of the Shelter, Inc.
211West 4th Street, Vinton, IA52349
This is an application only and not a guarantee for adoption
Date: ______
Basic Information:
Name:______
Address: ______
Phone Number: ______
Email Address: ______
Do you rent or own your home?: ______
If you rent, please provide your landlord’s name and phone number: ______
Do any of the members in your household have cat allergies?
(A) Yes (B) No
If you answered yes, please explain: ______
______
Animal Experience:
List any animals your currently own. Please include age, gender, breed and if they are spayed/neutered.
______
Have you ever had to rehome one of your pets? If yes, please describe the situation.
______
Please list the veterinarian(s) you have used in the past 2 years. Please include their name and phone number.
______
About Your New Pet:
Please list which pet(s) you are interested in and why this animal appeals to you: ______
______
What brand of food do you plan on feeding your new cat?: ______
What do you consider your house to be like?
(A) A library (B) Middle of the Road (C) A Carnival
Where do you intend to keep your new cat?
(A)Inside (B) Outside (C) Indoor and Outdoor
How much time will your cat spend alone each day?
(A)Less than 4 hours (B) 4-8 hours (C) 8 or more hours
How important is it that your cat is able to adjust to new situations quickly?
(A)Not important (B) Somewhat important (C) Extremely important
If the cat you adopt is not already declawed, will you have the procedure performed?
(A)No, never (B) Yes, for sure (C) Undecided
If you answered undecided, please describe the situation that you would have it done:
______
______
Do you want your cat to love being around children?
(A)Children rarely come to my house (B) Sometimes (C) Most of the time
(D) Indifferent
How often do you want your cat to enjoy being held?
(A)Little of the time (B) Sometimes (C) Most of the time
Does your cat need to get along with any of the following (circle all that apply):
(A)Cats (B) Dogs (C) Birds (D) Other: ______
Have you lived with cats before?:
(A)No (B) Yes (date:______) (C) Currently
It is most important to me that my cat: ______
By my signature below, I certify that I am at least 18 years old. The above statements about me, and my history with companion animals are true and correct. I understand that Friends of the Shelter, Inc. reserves the right to refuse any applicant for any reason. Any misrepresentation of fact may result in my application being rejected. My signature to this document also permits my present (or previous) Veterinarian or Animal Hospital to release requested information to an Friends of the Shelter, Inc. volunteer regarding my current or previously owned pets for the purpose of considering my application for a companion pet. I will not hold Friends of the Shelter, Inc. or any of its volunteers responsible for any actions incurred once the animal has been released from their care.
Signature: ______