Goathouse Refuge

Basic Information

Adopter's Full Name

Adopter's Age

Mailing address

Home phone

Cell phone

Work phone

Email address

Best way to contact you Email addressHome phoneCell phoneMailing address

Name of cat(s) you are interested in

Have you visited the refuge or met the cat(s)?

When did you decide to get a new cat?

What qualities are you looking for in a cat?

How did you hear about the Goathouse Refuge?

Household Members and Current Pets

Please list all members of your household, including family, roommates and frequent visitors, along with their names and ages

Does everyone listed above agree to getting a new cat?

Does anyone listed above have pet allergies?

Is anyone listed above a smoker?

Given the evidence about the effects of smoking on pets, we will need to know more about the extent of the smoking. If you answered yes above, please check one:  Outdoors Only Indoors and Outdoors

Have you owned cats as an adult?

Please list all pets that you currently own, names, ages and breeds

Please list all former pets, names, ages and breeds, and what happened to the pet

Are all of your pets current on their vaccinations?

Are all of your current cats FIV/Feline Leukemia negative?

Are all of your current cats spayed or neutered?

Are any of your cats declawed and was that your decision?

Would you ever consider declawing a cat?

May we contact your veterinarian?

Veterinarian's name

Veterinarian's location

Veterinarian's phone number

Other:  Don't have a veterinarian. Don't have veterinarian information available. Do not call my veterinarian.

About Your Home

What kind of home do you live in?
 Own Home Rent Condo / Townhouse Apartment Mobile Home Other

How long have you lived at your current address?

Do you have your landlord's permission for a new pet?

Your landlord's name and phone number

May we contact your landlord?

Do you have a screened porch or enclosed patio?

Who will be the primary caregiver of your cat?

How long are you gone each day?

Caring for Your New Pet

Are you employed? Check all that apply:
 Not employed Full time Part time Work at home Retired Undergrad student Graduate student Military

Are you prepared to make a 20 year financial and emotional commitment to this cat?

What kind of lifestyle do you want your new cat to have?
 Indoor only Outdoor only Indoor/Outdoor
What is your reason for this choice?

Where will the cat sleep at night?

How often do you travel?

When you travel, who will care for your cat?

How much responsibility will children be given in caring for your cat?

What will happen to the cat if you move?

What will happen to the cat if you have children?

How will you teach your cat?

What would you do if your cat developed a behavioral problem?

Are you willing to take your cat to a Vet for an annual physical and vaccinations?

Are you willing to provide regular tick and flea control?

A Day in the Life of Your New Cat

Please describe what a typical day will be like for this cat if he/she is adopted by you?

Name of a personal reference (other than a family member) and phone number

How do you know this person?

Do you have any objections to letting a rescue group volunteer visit your home for a pre-adoption home visit or follow-up visit after the adoption?

Are you a US citizen?

Are you planning to move out of the country at any time?

Signature

I am at least 18 years old. All the of the information I have given is true and complete. I understand that the Goathouse Refuge has the right to refuse my application. By typing my name in the space below I am applying a legal, digital signature.

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