Working Cat Adoption
$$TITLE$$
First Name
*
Middle Initial
*
Last Name
*
Date of Birth
*
Spouse First Name
Spouse Middle Initial
Spouse Last Name
Spouse Date of Birth
Your Street
*
City
*
State
*
---
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Home Telephone Number
Mobile Phone Number
Email Address
*
Do you have a preference for gender?
*
---
Female
Male
No Preference
What kind of shelter will the cat(s) have access to?
*
Barn
Brewery
Garage
Horse stable
Shop
Other
Do you have other cats that use this shelter?
*
No
Yes
How many cats live at this shelter?
*
Are your current barn cats spayed or neutered?
*
No
Yes
If you don't currently have barn cats are you willing to adopt a pair?
*
No
Yes
Have you previously had barn cats?
*
No
Yes
Are you able to provide fresh food and water on a daily basis?
*
No
Yes
If a barn cat becomes ill or injured do you agree to trap and take the cat to the vet?
*
No
Yes
Do you have a secure confinement area where the newly relocated cat(s) can be kept safely for 4 weeks?
*
No
Yes
Please describe the confinement space.
*
Do you own the property where the cat(s) will be located?
*
No
Yes
Do you agree to a site inspection?
*
No
Yes
How did you find Ten Lives?
Facebook
Instagram
Petfinder
Friend
Family
Other
By signing this application, I agree to the following: All statements made on this application are truthful; I have made no false statement with regard to family members in household, status of my home ownership and any other statements made on this application.
*
I agree
I disagree
Signature
*
Clear