Cat Adoption Application

Pet Name	Kahlua (Cat - C2312040) Peaches (Cat - C2309028)
If pet not listed, please type it here
Individual or Couple *	Individual Couple
Primary First Name *
Primary Last Name *
Primary Cell Phone *
Home Phone
Primary Email *
Secondary First Name *
Secondary Last Name *
Secondary Cell Phone *
Secondary Email
Street Address *
City *
State *	AR 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 *
Why do you want to adopt this pet?
	Companion for you
	Companion for other family member
	Companion for other pet
Current Veterinarian's Name, Phone Number * If you have never had a pet before please list the vet that you will likely use.
Name listed on vet records *
Previous Veterinarian's Name, Phone Number (if no current vet) *
Do you use low cost vet clinic, or vet listed *
List ages of everyone in household *
Primary Caretaker *
Family member allergies * Is there anyone in the home who may be adversely affected by dogs/cats (allergies, etc.)?	NoYes
Do all members of household want to adopt this pet? *	NoYes
Do you own your home? * If no, please provide landlord's name and phone number
Type of Residence * House, Townhouse, Condo, Mobile Home, Other
How long at present residence? Do you plan on moving in the near future?
Please explain *
How do you rate your pet experience?
	First Time Owner
	Beginner
	Intermediate
	Advanced
Please list the pets in household now, age, breed, & sex: Are they vaccinated? Spayed/neutered?
List Pets *
Tell us about any pets you have owned in the past 10 years: What happened to these pets?
List past pets *
Will pet wear collar and ID tag *	NoYes
How will you handle behavioral issues * Would you be willing to take the pet to obedience training?
How many hours a day will this pet spend without humans? *
When will the pet be inside? * All the time, at night, In and Out, Never
Where will the pet sleep at night *
Which of the following behavioral issues would prompt you to give up your pet? Check all that apply:
	Biting/Scratching Family Member
	Not Friendly with Guests
	Scratching Furniture or Carpet
	Shedding
	None
Which of the following reasons would prompt you to give up your pet? Check all that apply:
	Moving
	Having a baby
	Allergies
	Divorce
	New Spouse/Partner doesn't Like Pet
	Financial Problems
	Pet's Health Problems
	Excessive Veterinarian Bills
	None
Would you agree to a home visit by an Out of the Woods representative? *	NoYes
If there is any other relevant information you would like us to know *
Initial Here *

* Applicant must be primary caretaker of the pet being applied for.
* Applicant must be at least 18 years of age to fill out and submit an application.
* Please note we are unable to process incomplete applications.
* Check all entries for accuracy, then press the "Submit" button ONLY ONCE.
* If you do not receive a confirmation email after you hit Submit, please re-submit your application.