OLD - HBPR Cat Adoption Questionnaire

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Adopting a pet is a lifelong commitment that should be taken seriously. We strive to match owner lifestyles with pet personality, special needs and breed type so that your pet will benefit from a healthy, fulfilling relationship. Please start the process by taking a few minutes to fill out this questionnaire and submit it using the Submit button at the bottom of the page.

Applicants must be 21 years or older. * = Required information

HBPR Cat Adoption Questionnaire

First Name: * Your first Name
Last name: * What is your last name?
Your age * Select your age. Valid values are between 21 and 80.
Do you have a firm commitment from another adult to care for your cat if you no longer can? * Have you arranged for someone to care for a cat you adopt in the event you no longer can?
Street Address: * What is your street address used for mailing
Additional Street Address:
City: * What is the town or city?
State: * What is the state?
Zip code: * What is your zip code?
Primary Phone number: * What is your primary phone number?
Email address: * What is your email address?
Is there a coapplicant? * Is there another person to be included on the application?
Co Applicant First Name: * Co applicant's first name:
Co Applicant last name: * Co applicant (if any) last name:
Co applicant age *
How many cats are you interested in? * Do you want one or more cats?
Are you interested in a specific cat or just a general breed or type? * Are you interest in a general type of cat or a specific cat on our web site?
Name of animal you are interested in. *
Choose type of cat you are interested in *
Do you live in a *
Do you own your residence or rent it? *
Are you willing to provide written or verbal confirmation that you are allowed to adopt this cat? *
How many people share the residence with you? * How many other people live with you?
Are all your household members willing to confirm that they are in agreement about adopting a cat? *
How many members of the household are children? *
What are the ages of the children? * Select all that apply
Is there a possibility that you might move in the next 5 years? * Do you think you will be moving within 5 years?
When you move, is it possible your cat may not be able to come with you? *
Are there pets currently in your household? *
What are the species and ages of your current pets? * select all that apply
Are all current pets spayed/neutered? *
Who is your current vet? *
What is your vet's phone number? *
Are you willing to commit to medical care for your cat(s), from annual visits to vaccinations (including rabies), which we estimate can cost an average of $300-$500/yr for healthy cats, and probably much more for aging and ill cats? *
How many cats have you owned in the past? *
At what age did your previous cats die or leave you? * Select all that apply
From what did they die or leave you? * Select all that apply
Have you ever had your cats declawed? *
Do you intend to declaw this cat? *
Your current cats are *
You intend for this cat to be *
Please list the names, addresses and phone numbers of 2 personal references that are not related to you: *
Please provide the name and phone number of someone to contact in an emergency * An emergency contact name and number
Please feel free to provide any additional information about the information you provided, your situation, your household or environment or anything else pertinent to your application that could help us evaluate your viability as an adopter for our cat(s)
How did you hear about Homeward Bound?
Typing your name below will serve as legal signature. By signing below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of our rescue animals and possible removal of said animal from my home. Applicant must be 21 years of age or older. Homeward Bound reserves the right to refuse any applicant.
Please enter your name and submit the application: *

Homeward Bound Pet Rescue Inc. | PO Box 792 | Ellijay, GA | 30540 | 706-698-4663