EmailMeForm
Working Cat Adoption Application
Thank you for considering adopting from La Plata County Humane Society. You are not only finding a new family member, but you are giving an animal a second chance at a new life.
Please upload a copy of your current photo ID and proof of residence if not shown on your identification.
La Plata County Humane Society reserves the right to decline or postpone any adoption. I acknowledge that if any of the information on this application is false or misleading it is subject to denial.
For questions regarding the application process, please call (970) 259-2847.
Full Legal Name
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First
Last
Phone
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Secondary Phone
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Physical Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Email
*
Spouse/Emergency Contact (Full)
*
First
Last
Spouse/Emergency Contact Phone
*
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What type of dwelling do you live in?
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House
Apt/Condo/Townhome
Mobile Home/RV
Dorm
Other
If other, please explain:
Do you rent your home or lot?
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Yes
No
Landlord's name:
First
Last
Landlord's phone:
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How long have you lived at your current address? If less than two years, what is your previous address?
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Address:
Street Address
City
State / Province / Region
Postal / Zip Code
Please answer the following questions:
List all persons (yourself, adults, children, roommates, frequent visitors, etc.) at your current residence.
Name
Relationship
Age
Date of Birth
Full Legal Name
Full Legal Name
Full Legal Name
Full Legal Name
Full Legal Name
Full Legal Name
Is anyone listed above allergic to animals?
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Yes
No
Does everyone living in your residence know about and agree to your decision to adopt?
*
Yes
No
Please list all pets that live at or visit your current address.
Write "none" in animal "type" if no pets.
Type
Name
Breed
Age
Sex
Altered? Y/N
Length Owned
Indoor/outdoor, both?
Animal
Animal
Animal
Animal
Animal
Animal
Have you owned a pet in the last five years that is no longer with you?
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Yes
No
If yes, what happened to the animal?
Who is your current Veterinarian?
Veterinarian Name
First
Last
Phone
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What best describes what shelter the cat will have access to
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Barn
Shop
Garage
Cat House
Other
If other, please explain:
Do you currently have other cats that share this shelter?
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Yes
No
If yes, are the other cats spayed/neutered?
Yes
No
Some
Are there dogs that will be running loose in this area?
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Yes
No
Do you have the needed supplies/room to keep the cat confined until it acclimates to its new surroundings?
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Yes
No
Do you agree to confine the cat until it has had time to acclimate to its new surrounding, to provide food/water daily, and to provide shelter for the cat?
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Yes
No
Do predators such as coyotes, mountain lions, etc have access to your site?
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Yes
No
If yes, what measures do you plan on taking to keep the cat(s) safe?
Who will be responsible for your barn cat's care?
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How much are you willing to spend on medical bills if your new cat were to suddenly become ill or injured?
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Up to $100
Up to $500
Up to $1,000
What would you do if the bill exceeds this amount?
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Under what circumstances will you absolutely not keep this cat?
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How many/which barn cats are you interested in adopting?
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Why are you interested in adopting a barn cat?
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*I acknowledge that if any information is false or misleading my application it is subject to denial.
Signature
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Clear
Date
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MM
/
DD
/
YYYY
Upload valid photo ID
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Upload proof of residence, if not shown on photo ID
