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Cat Adoption Application

Today’s Date:      

Cat/Kitten your are interested in:      



Home Phone:       Work Phone:      

Cell Phone:

Do you own your own home?: Yes  No  Rent/Lease 

If you rent, are cats allowed?: Yes  No  Not sure 

What type of home do you live in?: (double click ) 

If you do not own your own home, landlords name and complex phone number:      

Please provide a brief history of pets you have previously owned (ie: gone due to illness, moved, etc.):      
Current pets you own (type & age):      
Are your current pets up to date on vaccines?: Yes  No 

Are your currents pets spayed/neutered?: Yes  No 

Are your current cats: Indoor only  Outdoor only  Both 

The new cat will be: Indoor only  Outdoor only  Both 

Are your current cats declawed?: Yes  No 

Are you having your new cat/kitten declawed? Yes  No  Not sure 

If you are, will they be declawed: Front only  Back only  All four 

Do you have children in the house?: Yes  No 

If so, what are the ages?:      

Do the children have experience with the pets?: Yes  No  Limited 

Does anyone in your home have pet allergies?: Yes  No 

Is this new cat/kitten for: You  Your family  Someone else 

Name & PHONE NUMBER of current or previous vet used:      
This cat needs to get along with: Children  Dogs  Other cats 

I hope this cat will enjoy: Being held  Sitting on laps 

I hope this cat will: Be affectionate 

Is shedding a problem?: Yes  No: 

Kitty-Korner Cat Rescue

Connie Hodge


Clare, Michigan 48617

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