165511 FMCA AdoptionApp09:165511 FMCA AdoptionApp09

Cash Donation: ______________
Invoice Number(s): ________________________
Cat’s Name: ______________________________
FRIENDS OF MONTGOMERY COUNTY ANIMALS, INC.
ADOPTION APPLICATION
Animal MUST reside with applicant. All information must be provided. (Please print legibly.)
Name: ______________________________________________________________________________________________
(Please include spouse or name(s) of other residents.)
Address: ____________________________________________________________________________________________
Street
City
State
Zip
Phone (Home): _________________________ (Cell): ____________________________ (Work): ____________________________
Email: ________________________________________________________________________________________________________
How long have you been at this address? __________ years __________ months
Do you: ____________ own
____________ rent
If renting, are you allowed to have pets? _________
Type of dwelling (single family, townhouse, apartment, etc.) __________________________________________________
Name of landlord/rental company: _____________________________________ Phone Number: ____________________
Number of adults: ______ children (18 and under) and ages: __________________________________________________
Hours someone is usually at home: _____________________
How late in the evening may we call?_________________
Have you adopted an animal from any humane society, shelter, rescue group, etc.? _________
If yes, what group: ____________________________________________________________________________________
Have you been refused adoption of an animal from any humane society, shelter, rescue group, etc.? ___________________
If yes, please explain: __________________________________________________________________________________
Are you fully aware of and financially prepared to deal with the costs associated with owning an animal (i.e.,vaccinations,
quality food, litter, etc., as well as “sick animal” and possible emergency expenses)? ________
What is the minimum cost you expect to incur in one year for the care of your cat(s)? ________
Our cats/kittens are counting on you to make a LIFETIME COMMITMENT to them. Many live to be 15-20+ years. Are
you willing and able to keep this commitment when considering major decisions such as marriage, children, moving,
school, etc.? __________
Are any of your cats declawed? ___________
How do you feel about declawing cats? ___________________________________________________________________
Has anyone ever explained to you exactly what is involved? _____ Are you aware of the alternatives to declawing? ____
Please explain: ______________________________________________________________________________________
Does anyone in your home have pet allergies? ______ Please explain: __________________________________________
Where will this cat/kitten be kept? (Read each option, then circle all that apply.)
1. yard
2. in home
3. garage
4. basement
5. other ____________
Who will be in charge of the cat/kitten’s daily care? __________________________________ Age (if under 18):________
Who will care for your pet during vacations?________________________________________
Please complete second page of Application Form
Page Two
Cat’s Name: _____________________
Will you contact us if you move so we know what happens to our cats? ________
We reserve the right to perform a home check. Please acknowledge with your initials. ________
If you have other pets at home, are you aware of the proper procedure for introducing your new pet(s) to your resident
pet(s)? ____________
Please list all pets living with you now:
1.
2.
3.
4.
5.
NAME
DOG
CAT
OTHER
AGE
M/F
LIVES
in
out
in
out
in
out
in
out
in
out
ALTERED?
yes
no
yes
no
yes
no
yes
no
yes
no
DECLAWED?
yes
no
yes
no
yes
no
yes
no
yes
no
Has/have the cat/cats you currently own been tested for feline leukemia? _______________
Please list all pets no longer living with you (within the last 20 years), including deceased pets:
1.
2.
3.
4.
5.
NAME
DOG
CAT
OTHER
AGE
M/F
LIVED
in
out
in
out
in
out
in
out
in
out
ALTERED?
yes
no
yes
no
yes
no
yes
no
yes
no
DECLAWED?
yes
no
yes
no
yes
no
yes
no
yes
no
Who is/will be your vet hospital? __________________________________________________________________________
(A list of local animal hospitals is provided for your convenience.)
How often will your cat or kitten visit the vet? _______________________________________________________________
Signature: ________________________________________________________________ Date: ______________________
Drivers License Number:________________________________________________ State:___________________________
Interviewer: Name: ________________ ID verified? ________ Note any discrepancies and resolution ________________
_____________________________________________________________________________________________________
FMCA USE ONLY
Applicant’s Name ________________________________________________
Cat’s Name _________________________ Invoice Number ______________
Description _____________________________________________________
Comments______________________________________________________
_______________________________________________________________
_______________________________________________________________