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Email: HYPERLINK "mailto:paws50@bellsouth.net" paws50@bellsouth.net
Phone/Fax: 321-752-5120
The following information is requested so we can assist you in the selection of a new cat. The cat�s welfare is our foremost consideration. The application is designed to help us determine if the adoption is in the cat�s best interest, and to assist you in finding a cat most compatible with your lifestyle.
Adoption application for (name or description of cats)
Name Spouse�s Name and DOB
Address City/State/Zip
Driver�s License # State DOB exp
Phone___________________Pager/Cell Email
Place of employment How long? Phone
Spouse employed by How Long? Phone
Do you rent or own?__________If you own, is it a home, townhouse, or condo?_______________________
If you rent, name of Community and Contact Info to verify pet security/deposit has been paid and number of pets allowed. ___________________________________________________________________________
Are you anticipating a move, pregnancy, marriage, new home, or any other major change anytime in the next
few months? Explain_____________________________________________________________________
______________________________________________________________________________________
Ages of children living in the household Permanently or occasionally?
Does anyone living in your household have any kind of medical condition�allergies, suppressed immune
system, diabetes, or taking blood thinners? No____ Yes_____If so, what is the condition?______________
______________________________________________________________________________________
Number of residents that smoke in the house__________________________________________________
Where will the litter box be kept?
Where will the pet be kept during the day?
How many hours will it spend alone without human companionship?
Do you plan to keep your pet (circle one) inside outside other (explain)
When do you plan to declaw (circle one) never immediately 4-6 months 1 year maybe
What pets do you currently have in your household?
Name Age Species Declawed? Spayed/Neutered? Shots up-to-date?
Cat Dog
other _____Yes No Yes No Yes No Cat Dog
other _____Yes No Yes No Yes No Cat Dog
other _____Yes No Yes No Yes No Cat Dog
other _____Yes No Yes No Yes No Cat Dog
other _____Yes No Yes No Yes No If more space is needed please use the same format as this, on the back of the application.
If any cats are listed above, what is fed and how often:
If any dogs are listed above, what breed or breed mixes is/are they:
List pets owned in the past 5 years, other than those listed above.
Species Name & Age What happened to this pet?
Cat Dog
other _____Cat Dog
other _____Cat Dog
other _____Cat Dog
other _____Cat Dog
other _____
Who is your veterinarian?
I attest that the information provided above is correct. I understand that this is only an application for adoption and does not constitute a contract or guarantee me to receive the pet applied for. PAWS has the right to refuse an adoption to any individual on any grounds. I give PAWS permission to verify the information provided on this sheet.
Signature Date
Page PAGE 2 of NUMPAGES 2
V08-2011
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