Cat Adoption Application

Applicant's First Name
Applicant's Last Name
Street Address
City
State
Apartment Number (if applicable)
Zip Code
Phone Number
Email Address
Alternate Phone Number
Date of Birth
Employer
Do you own or rent your home?	Own Rent Someone else owns the Home Someone else rents the Home
Please select your current residence type.	House Apartment Condo Townhouse Mobile Home Other
If you answered "other" above, please explain here:
If you rent, provide your landlord name and phone number
How long have you lived at this address?	Less than one month 1-2 months 3-6 months 6-9 months 9-12 months 1-2 years 3-5 years 6-10 years 10 + years
Do you own other pets at the current time?	NoYes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?	Yes No N/A
Are your pets current on their vaccinations?	Yes no n/a
Veterinarian's Name
Veterinarian's Address, City, State, and Zip Code
Veterinarian's Phone Number
Who will have primary responsibilty for the animal?
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
On average, how many hours per day will your pet be left alone?
Will this pet be predominantly living inside, outside, or both?	Inside Outside Both
Please provide a description of this pet's living conditions.
I agree not to have the cat I am adopting declawed for any reason	NoYes
I agree to provide a proper scratching post and litter box for this cat.	NoYes
I would consider my household to be like	Library Middle of the Road Carnival
Have you ever turned your dog or cat into a shelter?	NoYes
If yes, please explain?
I certify that his information is true and accurate to the best of my knowledge. I understand that the Washington County Johnson City Animal Shelter reserves the right to deny any application for any reason and that if I am unable to keep this animal for any reason I will return it to the WCJC Animal Shelter so that they can rehome this cat.	Clear

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