Cash Donation: ______________ Invoice Number(s): ________________________ Cat’s Name: ______________________________ FRIENDS OF MONTGOMERY COUNTY ANIMALS, INC. ADOPTION APPLICATION Animal MUST reside with applicant. All information must be provided. (Please print legibly.) Name: ______________________________________________________________________________________________ (Please include spouse or name(s) of other residents.) Address: ____________________________________________________________________________________________ Street City State Zip Phone (Home): _________________________ (Cell): ____________________________ (Work): ____________________________ Email: ________________________________________________________________________________________________________ How long have you been at this address? __________ years __________ months Do you: ____________ own ____________ rent If renting, are you allowed to have pets? _________ Type of dwelling (single family, townhouse, apartment, etc.) __________________________________________________ Name of landlord/rental company: _____________________________________ Phone Number: ____________________ Number of adults: ______ children (18 and under) and ages: __________________________________________________ Hours someone is usually at home: _____________________ How late in the evening may we call?_________________ Have you adopted an animal from any humane society, shelter, rescue group, etc.? _________ If yes, what group: ____________________________________________________________________________________ Have you been refused adoption of an animal from any humane society, shelter, rescue group, etc.? ___________________ If yes, please explain: __________________________________________________________________________________ Are you fully aware of and financially prepared to deal with the costs associated with owning an animal (i.e.,vaccinations, quality food, litter, etc., as well as “sick animal” and possible emergency expenses)? ________ What is the minimum cost you expect to incur in one year for the care of your cat(s)? ________ Our cats/kittens are counting on you to make a LIFETIME COMMITMENT to them. Many live to be 15-20+ years. Are you willing and able to keep this commitment when considering major decisions such as marriage, children, moving, school, etc.? __________ Are any of your cats declawed? ___________ How do you feel about declawing cats? ___________________________________________________________________ Has anyone ever explained to you exactly what is involved? _____ Are you aware of the alternatives to declawing? ____ Please explain: ______________________________________________________________________________________ Does anyone in your home have pet allergies? ______ Please explain: __________________________________________ Where will this cat/kitten be kept? (Read each option, then circle all that apply.) 1. yard 2. in home 3. garage 4. basement 5. other ____________ Who will be in charge of the cat/kitten’s daily care? __________________________________ Age (if under 18):________ Who will care for your pet during vacations?________________________________________ Please complete second page of Application Form Page Two Cat’s Name: _____________________ Will you contact us if you move so we know what happens to our cats? ________ We reserve the right to perform a home check. Please acknowledge with your initials. ________ If you have other pets at home, are you aware of the proper procedure for introducing your new pet(s) to your resident pet(s)? ____________ Please list all pets living with you now: 1. 2. 3. 4. 5. NAME DOG CAT OTHER AGE M/F LIVES in out in out in out in out in out ALTERED? yes no yes no yes no yes no yes no DECLAWED? yes no yes no yes no yes no yes no Has/have the cat/cats you currently own been tested for feline leukemia? _______________ Please list all pets no longer living with you (within the last 20 years), including deceased pets: 1. 2. 3. 4. 5. NAME DOG CAT OTHER AGE M/F LIVED in out in out in out in out in out ALTERED? yes no yes no yes no yes no yes no DECLAWED? yes no yes no yes no yes no yes no Who is/will be your vet hospital? __________________________________________________________________________ (A list of local animal hospitals is provided for your convenience.) How often will your cat or kitten visit the vet? _______________________________________________________________ Signature: ________________________________________________________________ Date: ______________________ Drivers License Number:________________________________________________ State:___________________________ Interviewer: Name: ________________ ID verified? ________ Note any discrepancies and resolution ________________ _____________________________________________________________________________________________________ FMCA USE ONLY Applicant’s Name ________________________________________________ Cat’s Name _________________________ Invoice Number ______________ Description _____________________________________________________ Comments______________________________________________________ _______________________________________________________________ _______________________________________________________________