Mostly Mutts Cat Adoption Survey

Your First Name: *
Your Last Name: *
Your Age: *
Street Address: *
City: *
State: *
Zip Code: *
Best Number to reach you at: *
Email: *
Have you previously adopted from Mostly Mutts? *
If Yes, pet's original name and year adopted
How did you hear about Mostly Mutts? *
Whom did you hear about us from?
Pet Preferences:
All applicants - Please complete this section even if you have named a specific cat. This will help us with matching should the cats you are interested in be unavailable or unsuitable.
Are you interested in a specific cat? *
Cat you are interested in: Leave field blank if you'd like us to help you make a match.
	Cat I am interested in is not listed
Cat Name/Description
If there is another cat you are interested in:
Gender Preferred: * You may choose more than one
Your New Cat
Are you adopting a pet to live: *
Are you willing to give this cat 30 days to decompress in your home? *
Are you planning to de-claw your cat? *
Are you prepared to care for a cat for up to 20 years? *
What will happen if your pet outlives you? *
Tell us why you feel you could provide a good home for this cat? *
Home Information:
Are there other adults in the house? *
Are there children living/visiting your home? *
What is the age of the Children? You may choose more than one
Pet Ownership:
How many Dogs do you currently own? *
How many cats do you currently own? *
What other animals do you own?
Are your animals currently spayed/neutered? *
Please contact your vet (s) to give permission to release your records to us. If your animals are seen by more than one vet please list them separately.
Name of Veterinarian (1)
Phone number of Veterinarian (1)
Name of pet OWNER the records would be under? (1)
Name of Veterinarian (2)
Phone number of Veterinarian (2)
Name of pet OWNER the records would be under? (2)
Have you ever surrendered an animal to a shelter or animal control or given a pet away in the last 2 years? *
Personal References:
Please contact your references to let them know to expect a call from us. NOTE: the call will be from an unfamiliar number-not Mostly Mutts.
Reference Name (1) *
Relationship *
Best Contact # *
Reference Name (2) *
Relationship *
Best Contact # *
PLEASE READ THE FOLLOWING AND SIGN BELOW. Mostly Mutts appreciates your patience and understanding throughout this application procedure. Please understand our goal is to make sure these animals are placed in only the best homes. The responsibility of Mostly Mutts is the best interest of the animal. Mostly Mutts has permission to contact my vet, landlord & references during the application process. Mostly Mutts has the right to refuse any adoption for ANY reason. This application remains the property of Mostly Mutts. A fully executed contract completes this adoption. I certify that the above information is true.
Applicant's Signature *
Date

Mostly Mutts Cat Adoption Survey

Pet Preferences:

Your New Cat

Home Information:

Pet Ownership:

Personal References: