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:
13) Please describe any past cats you have owned:
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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