Cat Adopter Survey

Name *

First Name

Last Name

Phone *

(###)

###

####

Preferred Contact Method *

Phone

Email

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

My reason for wanting a cat: *

Companion

Mouser

Family Pet

Barn Cat

My cat will stay... *

Indoors

Outdoors

Indoor/Outdoor

Occupancy Type *

I pay rent-Landlord info. required below

I personally own my home

I reside in student housing

I live in retirement housing

I live with a parent or family

Landlord/Housing Director/Owner Name

First Name

Last Name

Landlord/Housing Director Phone

(###)

###

####

Do you have a valid NYS ID? *

Government-issued identification is required. Must be 18 years of age to adopt.

Yes

No

Do you have any current pets? *

Yes

No

No, my beloved pet recently passed

Are your current animals spayed/neutered? *

Yes

No

I have never had a pet

I don’t currently have a pet

If you have pets, are they current on vaccinations *

Yes

No

N/A