Name:
Date of Birth
Address, City, State, ZIP
Phone Number
Email Address:
Occupation
Employer
List the Names and Ages of People living in your household
Does anyone in your household object ot having the pet for which you are applying? Please add explanations if necessary.
Does anyone living in your household have allergies which may be aggravated by a pet?
Yes
No
Name all the pets and ages you have owned in the last 5 years, including their breed and what happened to them.
Are all of your pets spayed or neutered?
Yes
No
Are all of your pets current on their vaccinations?
Yes
No
Name and Phone Number of your Regular Vet
Housing Information
Rent
Own
If you rent, please provide the name and number of your landlord:
Will your landlord allow you to have pets
Yes
No
Describe your fencing situation if you have a fenced in area
Where will your pet stay during the day?
Outside
Inside, Freeroaming
Crated Inside
In a specified area inside
If adopting a cat, would you have the pet declawed?
Yes
No
Maybe
Do you understand that owning a pet is a long-term commitment, lasting sometimes as long as 15 or more years and that, in adopting a cat, you are committing to that pet and that you will give him/her a good environment and proper vet care for the remainder of his or her life? Please explain.
Name of pet you are applying for
Would you be interested in fostering or volunteering for Creatures Great and Small
Yes
No
Maybe