Name
*
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Phone Number
*
(###)
###
####
Age
Occupation
If your primary occupation is student or you are currently unemployed, how do you plan to cover the cost of veterinary care, food, litter, etc?
How did you hear about City Kitties?
Family, Friend, or Coworker
PetFinder.com or AdoptaPet.com
Clark Park Farmer's Market
The Cat Doctor
Baltimore Pet Shoppe
Fairmount Pet Shoppe
Internet Search
Flyer/Poster
Other
Have you applied (or do you plan to apply) to other rescue organizations in the Philadelphia area?
Yes
No
If yes, which ones?
In the past year, has your application been turned down by another rescue organization/shelter? Note: This will not necessarily disqualify you if circumstances have changed.
Yes
No
Do you rent your home/apartment? (For homeowners, City Kitties checks proof of ownership through the Philadelphia BRT online database.)
Homeowner
Renter
If you rent, do you have permission from your landlord to have a cat? City Kitties will call to confirm this.
Yes
No
Landlord Name & Phone Number
The average life span of an indoor cat is 15-18 years. Some cats live more than 20 years. Are you ready and willing to make a commitment to an animal for its entire life?
Yes
No
The ASPCA estimates that the first year of care for a cat (food, litter, vet care) totals $1,035. This amount could be considerably higher if your pet becomes sick or injured. Are you willing to take on this financial responsibility?
Yes
No
Why are you interested in adopting a rescued/formerly stray cat?
Please describe the other people you live with (spouse/partner, relatives, roommates, children). Is anyone in your household allergic to cats?
Does anyone in your household smoke inside the home?
Yes
No
I am interested in adopting a specific animal (enter name/s below, if applicable).
Did you see this animal at Baltimore Pet Shoppe or Fairmount Pet Shoppe?
Yes
No
I want to adopt (check all that apply):
Young kitten (6 months or under)
Adolescent kitten (7-11 months)
Young adult (1-3 years)
Adult (4-10 years)
Senior (10+ years)
I would like an animal like this (check all that apply):
Female
Male
Shorthair
Longhair
Energetic/playful
Laid-back/calm
Only pet
Companion for current cat
Good with children
Good with dogs
FIV+
Leukemia (FeLV)+
Disabled
Where would the animal live?
Outdoor-only
Indoor-only
Indoor with some outdoor access (pet door, allowed outside during the day, etc.)
Indoor with restricted/supervised access to enclosed porch/patio
You come home one day to find that your cat has urinated on the floor or furniture. What would you do? What would you do to prevent it from happening again?
You see your cat scratching the furniture. How would you deal with this issue? Please be specific and answer in complete sentences.
What type of vet care do you believe is appropriate? How often? Please be specific and answer in complete sentences.
How will the cat/kitten be cared for when you are out of town?
What will happen to the cat if you move locally? Out of state?
Under what circumstances would you not keep the cat/kitten?
Divorce/separation
New baby
Not enough time for a pet
Develop allergies
New apartment/condo doesn't allow pets
Veterinarian bill over $1,000
Scratches furniture destructively
Aggressive behavior
Not using the litterbox consistently
None of the above
If you checked any of the above, or if there is another circumstance that might prevent you from keeping a pet, please explain further below:
If you've owned a cat before, have you ever declawed any of your cats/kittens?
No
Yes
Not applicable (never had a cat)
Would you consider declawing an adopted cat/kitten?
Yes
No
Please provide the following information for each animal currently living in your household:
Have you ever had a pet before (not including current pets)? If yes, please provide the following information for each previous pet:
How many litters of puppies/kittens have the above animals had?
Have you ever had to give up or re-home a pet? If yes, what were the circumstances?
Clinic Phone Number
(###)
###
####
Name of person with account
Name of animals under the account
If there is any other information you would like to provide about your pets' veterinary care, please type it below
Reference 1 Name
Only for applicants who have not had a pet in the past 5 years. References should be familiar with your experience with animals (not relatives).
First Name
Last Name
Reference 1 Phone Number
(###)
###
####
Reference 1 Email Address
Reference 1 relationship to you
Reference 2 Name
First Name
Last Name
Reference 2 Phone Number
(###)
###
####
Reference 2 Email Address
Reference 2 relationship to you
Reference 3 Name
First Name
Last Name
Reference 3 Phone Number
(###)
###
####
Reference 3 Email Address
Reference 3 relationship to you
If you wish to give City Kitties additional information, please include it here