Cat Adoption Application Please make sure you have reviewed our Adoption Process and our Privacy Policy before filling out this form. Your Name*FirstLast Phone 1* Email* Address* Street Address City State Postal / Zip Code Date of Birth*01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 1999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930year Phone 2 Drivers License Number*Driver's License information and identification validation is required by the State of Missouri Department of Agriculture. Upload a photo copy of your Drivers License.Your Decision To Adopt A Cat Why do you want to adopt a cat?* What age cat are you looking for?*KittenAdultSenior Have you ever owned a cat?*YesNo When did you decide to get a cat?* What qualities are you looking for in a cat?*Family Member SupportFamily members must be consulted and agree to the adoption of a cat prior to consideration of your adoption request. Please list the names of family members aware of this adoption and their level of support. Name #2 Family Member Name #3 Family Member Name #4 Family Member Name Level of Support #2 Their Level of Support #3 Their Level of Support #4 Their Level of Support Age #2 Family Member Age #3 Family Member Age #4 Family Member AgePast and Present Pets Your Veterinarian Name* How many and what kind of animals do you currently have?* Veterinarian Phone Number* Will you authorize your veterinarian to release your records to us?*YesNo Please explain why you will not allow us to view your pet medical records.Pet #1 TypeDogCatOther Indoor or OutdoorIndoorOutdoorBoth Spayed / Neutered?YesNo Living or DeceasedLivingDeceasedNo longer have If deceased or you no longer have the pet, what was the cause? Pet #2 #2 TypeDogCatOther #2 Indoor or OutdoorIndoorOutdoorBoth #2 Spayed / Neutered?YesNo #2 Living or DeceasedLivingDeceasedNo longer have #2 If deceased or you no longer have the pet, what was the cause? Pet #3 #3 TypeDogCatOther #3 Indoor or OutdoorIndoorOutdoorBoth #3 Spayed / Neutered?YesNo #3 Living or DeceasedLivingDeceasedNo longer have #3 If deceased or you no longer have the pet, what was the cause?Your Cat's New Home Do you own or rent your home or apartment?RentOwn Landlord Name Landlord Phone Have you consulted with your landlord regarding this adoption? YesNoFor the sake of the cat's future well-being we strongly recommend that you consult with your landlord before proceeding with this adoption request. May we contact your landlord?YesNo Where will your cat live?*InsideOutsideInside and Outside Describe the shelter available to your cat while he/she is outside. Will you have your cat declawed?*YesNo What will you do if your cat claws your furniture or...?* Where will your cat sleep?* Where will your cat stay when you are at home?* Where will your cat stay while you are away?* Check any and all of the following reasons you would give your cat away.*FleasAllergiesToo ExpensiveHaving a babyGetting married or divorcedChews or destroys household itemsChildren will no longer care for itSheds too muchMoving to a place that doesn't allow petsOther Explain if Other How much do you estimate a cat will cost per year?* How long do you expect a cat to live?* Would you have any objections if a WarmFuzzys Adoption Volunteer made a follow-up visit to the new home of the cat after adoption?*YesNo Please explain the reason for your objectionReferencesList three personal references. Do not list a Family Member or Significant Other #1 Name* #2 Name* #3 Name* Reference Phone* ref2Phone* ref3Phone* Length of relationship* #2 Years you have known this person?* #3 Years you have known this person?* Any additional information you would like to tell us If for any reason I am unable to keep this cat I agree to return it to WarmFuzzys*YesNoNote: WarmFuzzys reserves the right to refuse adoption to anyone for any reason and to confiscate any animal due to false information presented on this adoption application or during an adoption interview. No animals will be adopted to persons with a history of losing, giving away, selling, injuring or having animals killed by automobiles. No animal will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application. Adoption fees are non-refundable. reCAPTCHASubmitResetNote: Click the Submit button one time and wait. It may take a few seconds for the files to upload and the posting of the form to complete.
