Full Name
*
First Name
Last Name
Email Address
*
Best Phone to Reach You
*
(###)
###
####
Street Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Subject
*
Message
*
Occupation
*
Your Title & Brief Job Description
Employer Information
*
Best contact, Title, Phone Number and Mailing Address.
Spouse/Partner/Children/Roomate
*
How many people live in your household and how are you related? What is their age and name?
Employer Information for Additional Adults
*
Reasons for Adopting
*
Tell us in a bit more detail your reasons for adopting based on what you chose above.
Sex of Dog
*
Male, Female, Either one is fine with me...
Breed
*
Temperament and Type
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Playful / Energetic
Housebroken
Obedience Trained
Non-Shedding
Lap Dog
Child Friendly
Dog Friendly
Cat Friendly
Will this be your first dog?
*
Yes
No
What pets have you had in the past?
*
Please include age, sex and breed
Which of the pets mentioned above do you still have?
*
What happened to the pets you no longer have?
*
If deceased, from what cause? Why did you give them away?
Have you ever had to find another home for one of your pets?
*
If yes, please explain in detail.
Have you ever had to surrender a pet to a shelter?
*
If yes, please explain in detail.
Have you ever had to have a pet euthanized?
*
Please explain in detail.
If applicable, are your current pets:
*
Please check all that apply
What brand(s) of food do you feed them?
*
How much are you willing to spend annually on medical bills?
*
Up to $100
Up to $500
Up to $1,000
Up to $5,000
What would you do if the veterinary bill exceed the amount selected above?
*
Would you ever euthanize an animal?
*
Yes
No
What type of residence do you live in?
*
Apartment
Townhome / Condo
Single Family Dwelling
Home with land
Other
Do you rent or own?
*
Rent
Own
Do you have written permission from your landlord to have a dog?
*
Yes
No
N/A
Landlord Name
First Name
Last Name
Landlord Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Landlord Phone
(###)
###
####
How long have you lived at your current residence?
*
Under 1 year
1 - 3 years
5 + years
Do you plan on moving anytime soon?
*
Yes
No
If you plan on moving do you plan on taking your animals with you?
*
Yes
No
Do you have a yard?
*
Yes
No
If you have a fenced yard, please describe below
*
Type and height
If no, where will you exercise your dog/puppy?
*
Do you have screens on all your windows?
*
Yes
No
Is anyone in your home allergic to pets?
*
Yes
No
What is the age of everyone in the household?
*
If you live with your parents, what restrictions or preferences have they stated?
*
Age, type of breed, sex of dog, etc
Will you be the person responsible for caring for your new dog? If no, who will?
*
How long will the dog be left alone during the day?
*
Where will the dog be kept while alone and you're away from home?
*
If you go away, or on vacation for a few days, who will take care of the dog?
*
How will your new dog spend it's days?
*
Please check all that apply.
How will your new dog spend it's nights?
*
Please check all that apply.
What will you do if the dog shows behavioral problems?
*
Are you willing to go through professional obedience training with your new dog, if necessary?
*
Are you willing to make a commitment and take responsibility for this dog to provide medical care, proper nutrition, and loving attention for the next 5 to 18 years?
*
Yes
No
Have you considered providing for your pets in your will? What provisions will you make for the dog should you become unable to care for it?
*
Veterinarian's Name
*
First Name
Last Name
Veterinarian's Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Veterinarian's Phone
*
(###)
###
####
Reference 1 Name & Relationship
*
Must be someone other then a family member. Please list your relationship to them and how long you've known them.
Reference 1 Phone
*
(###)
###
####
Reference 2 Name & Relationship
*
Must be someone other then a family member. Please list your relationship to them and how long you've known them.
Reference 2 Phone
*
(###)
###
####
Reference 3 Name & Relationship
*
Must be someone other then a family member. Please list your relationship to them and how long you've known them.
Reference 3 Phone
*
(###)
###
####
May we see your Drivers License?
*
All of the information I / We provided in this application is true and correct. I / We give C.A.T.S. permission to check all references stated. If any of the information changes, I/ We will advise C.A.T.S. Inc. immediately.
*
APPLICANTS ELECTRONIC SIGNATURE. Please indicate you agree by entering your full legal name below starting with "s/" .