EmailMe Form - ADOPT A KITTY!

EmailMeForm

NAME OF CAT/KITTEN YOU WANT TO ADOPT: *
YOUR NAME *
First Last
E-MAIL ADDRESS *
HOME PHONE *
### - ### - ####
CURRENT ADDRESS: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
CELL PHONE (IF APPLICABLE)
### - ### - ####
HOW OLD ARE YOU? *
UNDER AGE 21
AGE 21 TO 30
AGE 31 TO 45
AGE 46 TO 59
AGE 60 TO 75
OVER AGE 75
DATE OF BIRTH *
MM / DD / YYYY
HOW LONG HAVE YOU LIVED AT YOUR CURRENT ADDRESS? *
LESS THAN 1 YEAR
1 TO 5 YEARS
5+ YEARS
DO RENT OR OWN YOUR HOME? *
RENT
OWN HOME
PLEASE GIVE YOUR PREVIOUS ADDRESS IF LESS THAN 1 YEAR AT CURRENT ADDRESS:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
IF YOU RENT, PLEASE LIST THE NAME OF YOUR LANDLORD. *
IF YOU OWN YOUR HOME USE N/A TO COMPLETE THIS FIELD.
LANDLORD'S PHONE NUMBER: *
IF YOU OWN YOUR HOME USE N/A TO COMPLETE THIS FIELD.
ARE THERE CHILDREN LIVING IN YOUR HOME? *
YES
NO
IF SO, WHAT ARE THEIR AGE(S)? *
INFANT
1 TO 5
5 TO 7
8 TO 12
13 TO 18+
N/A
HAVE YOU EVER OWNED A CAT? *
YES
NO
HAVE YOU EVER OWNED A KITTEN? *
YES
NO
IF YOU ARE INTERESTED IN ADOPTING A KITTEN, WILL YOU BE ABLE TO PROVIDE PLENTY OF ONE ON ONE PLAY TIME? *
YES
NO
N/A
KITTENS ARE TYPICALLY VERY CURIOUS & HIGH ENERGY. IF YOU ARE INTERESTED IN ADOPTING A KITTEN, HOW WILL YOU "KITTEN PROOF" YOUR HOME & PROVIDE A SAFE ENVIRONMENT FOR THEM? *
IF YOU ARE NOT ADOPTING A KITTEN, USE N/A TO COMPLETE THIS FIELD.
IN A MULTI-CAT HOUSEHOLD, HOW MANY LITTER BOXES SHOULD BE PROVIDED? *
1
2
1 PER CAT
WHAT IS THE BEST WAY TO PREVENT INAPPROPRIATE SCRATCHING (FURNITURE, ETC.)? *
USE A SPRAY BOTTLE
SCOLD THE CAT USING A LOUD VOICE OR A SPANK
PROVIDE SCRATCHING BOARDS
PROVIDE A CAT TOWER/SCRATCHING POST
IGNORE IT
PLEASE CHECK ALL THAT APPLY.
WHAT EXPECTATIONS DO YOU HAVE FOR YOUR NEW KITTY? *
LAP/MELLOW CAT
HIGH ENERGY CAT
COMPANION CAT
CAT FOR CHILDREN
GETS ALONG WITH DOGS
GETS ALONG WITH OTHER CATS
PLEASE CHECK ALL THAT APPLY.
HOW MANY HOURS A DAY (ON AVERAGE) WILL YOUR CAT OR KITTEN SPEND ALONE (WITHOUT HUMAN COMPANY)? *
1 - 3 HOURS A DAY
4 - 8 HOURS A DAY
8+ HOURS A DAY
WHEN ON VACATION OR OUT OF TOWN, WHAT WILL YOU DO WITH YOUR KITTY *
BOARD THE CAT
HAVE A FRIEND, NEIGHBOR OR FAMILY MEMBER CARE FOR THE CAT
PUT OUT EXTRA BOWLS OF FOOD & WATER IN THE HOME
DO YOU OWN A CAT CARRIER? *
YES
NO
IS ANYONE IN YOUR HOUSEHOLD ALLERGIC TO PETS? *
YES
NO
PLEASE LIST ALL PETS IN YOUR HOUSEHOLD *

TYPE OF PET(S):

AGE(S) & DESCRIPTION(S) OF PETS:

IF YOU DO NOT OWN ANY PETS, PLEASE USE N/A IN BOTH BOXES TO COMPLETE THIS FIELD.
ARE YOUR PETS SPAYED/NEUTERED? *
YES
NO
N/A
DO YOU CURRENTLY HAVE A VETERINARIAN? *
YES
NO
VETERINARIAN'S NAME OR CLINIC/ANIMAL HOSPITAL:
WHEN SHOULD YOU TAKE YOUR KITTY TO SEE A VET? *
ONLY IF IT GETS SICK
EVERY FEW YEARS
ONCE A YEAR
VETERINARIAN'S PHONE NUMBER
### - ### - ####
HAVE YOU EVER INTRODUCED A NEW PET INTO YOUR HOUSEHOLD? *
YES
NO
HAVE YOU EVER SURRENDERED A PET TO A SHELTER OR ANOTHER INDIVIDUAL? *
YES
NO
IF SO, PLEASE EXPLAIN THE CIRCUMSTANCES:
SHELTER KITTIES HAVE A WIDE RANGE OF PERSONALITIES & LIFE EXPERIENCES. ARE YOU WILLING TO GIVE YOUR NEW KITTY AT LEAST 2 WEEKS OR MORE TO ACCLIMATE? *
YES
NO
WILL YOU KEEP THIS CAT: *
INDOORS ONLY
INDOORS & OUTDOORS
OUTDOORS ONLY
IN THE EVENT SOMETHING SHOULD HAPPEN TO YOU ( I.E. - DIVORCE, DEATH, MOVE INTO ASSISTED LIVING, ETC.) & YOU CAN NO LONGER CARE FOR THIS CAT, WHAT WOULD HAPPEN TO THE CAT? *

TYPE OF PET(S):
AGE(S) & DESCRIPTION(S) OF PETS: