Providence Animal Control
CAT Adoption Application
Log # _______ Cage #: ________ Sex: _______ Today’s Date: ___________________
Breed: __________________________ Color: _______________________________
APPLICATION DOES NOT GUARANTEE APPROVAL
Name of Primary Caretaker/Legal Owner: ____________________________________________
Age: ____________ Occupation: ________________________________________________
Cell phone: __________________________ Work phone: _________________________
Address where pet will reside: ____________________________________________________
City: _______________________________ State: ________ Zip code: _______________
1) Please list everyone who will live with, care for or frequently visit this pet:
Gender
Will live with cat
Will visit
Will care for
Has met this cat
M / F
M / F
M / F
M / F
M / F
2) Please describe your living situation: (circle answer)
A) Single-family home Multi-family home Apartment Condo Duplex Dorm
B) Homeowner Renter With parents
3) How long have you lived at the above address? _________________
4) Homeowner/Landlord Name: _________________________ Phone #: _________________
(If you rent, a notarized letter of permission for THIS particular cat is required.)
5) Do you plan to de-claw this cat? Yes / No / Unsure
6) Will the cat be allowed outside? Yes / No / Unsure / Only when supervised
7) Please describe your neighborhood: Rural City Quiet Noisy Busy street
8) Average number of hrs. the cat will be home without people: _______ hrs, _________days per wk
9) Where will the cat be kept when you are not home (ex. Work, outings)? (circle answer)
Loose in house Crate Confined to room/area of house Finished basement Unfinished basement
Other: ____________________________
11) Where will the cat be kept at night? (circle answer)
Loose in house Crate Confined to room/area of house Finished basement Unfinished basement
Other: ____________________________
12) Please describe all animals this cat will live with or frequently visit:
Species
Breed(s)
Spayed/Neutered
Live together
Visit frequently
13) Please describe any past cats you have owned:
Breed/Mixes
Spayed/Neutered
Age
Yrs. Owned
Where is cat now?
14) List any past veterinarians or veterinary clinics you took your pet to:
________________________________________________________________________________
15) Does anyone in your home have cat allergies? (Yes / No / Unsure )
The information I have provided is accurate and true to the best of my knowledge and I
authorize Providence Animal Control to verify any information I provided. It is in my
understanding that any false information will result in adoption refusal. I understand
Providence Animal Control may refuse any adoption.
__________________________________________ ______________________________________
Print Applicant Name Applicant Signature
STAFF USE ONLY
Approved by: _________________________ Date: _____________________
Denied by: ___________________________ Reason for denial: ____________________________
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