mail application to:
The Purr-fect Cat Shelter, Inc
Post Office Box 548, Medway, MA 02053    508 ·  533 ·  5855

ADOPTION QUESTIONNAIRE
The aim of the Purr-fect Cat Shelter is to find good quality, permanent homes for every cat. Completion of this form enables PCS to ensure a good match between you and the cat you select and that the adoption is in the best interest of both the cat and the owner. There are no right or wrong answers to these questions. Our goal is to place the cat in the best possible home. PCS hopes that you agree that the animal's welfare must be the first consideration. Please be patient, PCS is staffed completely with volunteers doing their best to serve you.
To be considered for an adoption, you must:
1. Be at least 18 years of age.
2. Have the knowledge and consent of all adults living in your household.
3. Have a verifiable means of identification.
4. Have your landlord's consent to bring an animal onto the property.
5. Agree the Purr-fect Cat Shelter has the right to deny any application.
Printed Name E-mail address
Home Phone Work Phone
Street
City State Zip
Driver's License No. State Exp. Date
For whom are you adopting? [] Yourself [] Household [] Someone else-If so, whom?
Household: Number of Adults_____ Number of Children_____ Ages of Children_____
Are the other members of the household aware you are adopting a cat? [] Yes [] No
Does anyone in the household have allergies to pets? [] Yes [] No
For what purpose are you adopting? [] Family Pet [] For a Child [] Mouser [] As a companion for another pet
Where will the cat be kept at night or when it is alone? [] House [] Cellar [] Caged [] Outside [] Garage
Type of cat desired: [] Adult [] Male [] Indoor only [] Barn Cat
[] Kitten [] Female [] Outdoor Only [] Declawed
[] Doesn't Matter [] Doesn't Matter [] Indoor/Outdoor  
Do You Live: [] In a House [] In an Apartment [] In a Condo [] In a Dormitory
[] With Parents [] Own [] Rent  
How long have you lived at this address? Landlord's Name
Address Phone No.
Do you plan to move? [] Yes [] No
If YES, what will you do you with the cat?
Cats often live longer than 15 years, are you prepared to take responsibility for the pet's entire life?
Please consider moving, children, planning to have children, teenagers off to college, etc.		 [] Yes [] No
Who will be responsible for litter training, care, and feeding of the cat?
Is this person present? [] Yes [] No
Will someone be home with the cat during the day? [] Yes [] No
If NO - how many hours will the cat be left without human companionship?
Do you travel? [] Yes [] No
If yes, how will you provide for your pet while you are away?
It may take several weeks for a pet to adjust to a new home, are you prepared to allow for this much time? [] Yes [] No
Do you have knowledge of the pet responsibility laws in your community? [] Yes [] No
Yearly care for a cat averages $200 - $250. Is this an expense you are able to undertake? [] Yes [] No
Will the cat be an "indoor" cat? [] Yes [] No
Do you want to have the cat declawed? [] Yes [] No
If yes, why?
List the pets you currently have in your household:
Name Type/Breed Kept Where Age Altered Male/Female
           
           
           
           
Do any of the cats in the household go outdoors? [] Yes [] No
If YES, have they been vaccinated against Leukemia?
Often you may have to separate new pets from existing ones in order to introduce them in a calm pleasant manner. Can this be done in your home? [] Yes [] No
If NO, please explain:
If you don't have a pet at this time, have you ever owned a pet? [] Yes [] No
If YES, what happened to them?
Who is your current/past Veterinarian? NAME:
ADDRESS PHONE
Where did you hear about the Purr-fect Cat Shelter?
Have you adopted a pet from us before? [] Yes [] No
If YES, when, and under what name?
Do you still have the pet? [] Yes [] No
If NO, why?
Have you ever brought an animal to a shelter? [] Yes [] No
If YES, why?
Since many shelter animals have unknown medical histories, are you prepared to provide and pay for any necessary medical treatment that may occur in the future? [] Yes [] No
Would you object to a Shelter Representative visiting your home to check on the pet's well-being? [] Yes [] No
Please list two references:
1.) Name
Address Phone
2.) Name
Address Phone
I UNDERSTAND THE ABOVE QUESTIONS AND AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. FURTHER, I GIVE THE PURR-FECT CAT SHELTER PERMISSION TO CONTACT MY REFERENCES, VETERINARIAN, AND/OR LANDLORD TO VERIFY SAID STATEMENTS. I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS CALLED FOR IS CAUSE FOR DENIAL OF ADOPTION.
Signature Date

FOR SHELTER USE ONLY
ADOPTION COUNSELLOR: CASE NO.:
APPROVED BY: CAT'S NAME:
APPROVED DATE
NOT APPROVED: