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
              
                * 
              
             
          
                
                
                
                  
                    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/" .
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              How did you hear about the C.A.T.S. organization?
              
                * 
              
             
          
                e.g., Facebook, Instagram, Google, friends, etc.