* Indicates required field

Name of the cat(s) you are interested in: *

Where did you meet the cat(s): *
Schwartzy's Cat CoveHeritage Humane SocietyPetSmart
Last Name: *

First Name: *

Spouse/Partner/Roommate Name (First, Last Name):

Birth Date: *

Age: *

Address: *

City: *

State: *

Zip Code: *

Email: *

Phone Number: *

Employeer:

How many adults live in your household? *
—Please choose an option—12345678910
How many children live in your household? *
—Please choose an option—012345678910
If there are children living in your household or children who visit your household please list their age(s):

If there are children in your household, have they been around pets?
N/AYESNO
Is anyone in your household allergic to pets? *
NODOGSCATS
If you selected YES, how is it managed?

What is your living situation? *
I own my homeI rentI live in military housingI live with parents/relative
If you don't own, what is the contact information for the owner/manager?

If you don't own, what is the pet policy?

Are there any major changes in your near future? *
NoneMovingBirth of childWork or Schedule ChangeFamily members moving in or outDeploymentOther
If you selected OTHER, please specify:

If a change is expected, how will this affect your new pet?

If you have any other pets, are the pet(s) current on their vaccinations? *
N/AYESNO
If you have any other pets, are the pet(s) spayed/neutered? *
N/AYESNO
Please describe each of your pets. (name, species, time owned, where are the pets primarily housed (indoor or outdoor)):

Which veterinarian/vet practice do you use and may we contact them? *

Are you able to provide vaccine history and/or vet records for your pet(s)? *
N/AYESNO
Have you ever put an application on a pet at HHS before? *
YESNO
Have you adopted from HHS before? *
YESNO
If YES, which pet(s) and when?

Have you ever had to turn in a pet to a shelter or rehomed a pet? *
YESNO
If YES, what was the reason and where did the animal go?

_____________________________________________________________________________________________________________________________________________________
We want to make sure the pet you have chosen is a good fit for your household. Please answer the following questions about your expectations and plans for the pet.
Are you committed to providing for a pet for its lifetime (12 to 20+ years)? *
YESNO
Are you prepared to take your pet for a complete physical exam and to provide any necessary medical treatment, along with annual shots and recommended veterinary care? *
YESNO
What are the reasons for adopting a cat? *
CompanionChild's PetCompanion for other petGift for someoneOther
If you selected OTHER, please specify:

What energy level would you like in a cat? *
LowMediumHighDoesn't Matter
Are you prepared to spend $400 - $700 a year for pet expenses (food, medical, vet care, grooming)? *
YESNO
What would you do if your cat developed litter box problems? *
Check with my vetAttempt to retrainUnsure and need guidanceOther
If you selected OTHER, please explain:

Do you plan on declawing this cat? *
YESNOUnsure and need guidance
If you answered YES, for what reason?

If you have other pets, how will you introduce this cat? *
Keep separate at firstSlowly over several daysJust put togetherUnsure and need guidance
Under what circumstances would you give up this pet? *
Destructive to furniture/carpetingLitter box accidentsScratches peoplePet medical expensesMoving/deploymentLifestyle changes (baby, development of allergies, etc.)Other
If you selected OTHER, please specify:

Have never been convicted of animal cruelty, neglect or abandonment? *
YESNO
I certify the above information to be true and correct and authorize verification of all statements presented in this application and that I am 18 years or older. *
I certify
I understand that at the time of adoption this application becomes part of a legally binding contract and that any false statements or breach of contract entitles the Heritage Humane Society to reclaim the adopted pet and/or gives HHS the full ability to prosecute for the performance of this contract. *
I consent to these conditions
I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if any omission or untruth is discovered after an adoption takes place, I understand that Heritage Humane Society reserves the right to annul the adoption and reclaim the animal. I give the shelter permission to fully investigate the information provided as well as contact veterinarians, landlord (if applicable), and related officials.
I consent to these conditions
In addition, I understand the adoption decision is dependent on many factors, including but not limited to the compatibility of the family and home to the individual animal, and other applications received on this animl. I understand it is the Heritage Humane Society’s prerogative to decide which home is most appropraite and that their decision is final, and therefore I will not argue with the decision. Unless otherwise indicated by the Heritage Humane Society, I am free to apply and undergo the application process in the future.
I consent to these conditions
Driver's License Number: *

I agree to the above conditions (Type your full name): *

Today's Date: *