Feline Adoption Application                                     Ocooch Mountain Humane Society                                  Richland Center, Wisconsin
Please answer all required questions. Failure to do so will result in an automatic rejection of this application, including absence of landlord contact information. The Ocooch Mountain Humane Society reserves the right to reject any application that is submitted. In order to become a candidate to adopt you must:
-Be at least 18 years old
-Have knowledge and consent of all adults living in your household
-Have a valid proof of address and provide landlord contact information if a renter
-Understand that OMHS reserves the right to refuse the adoption of any animal for any reason

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Email *
Name *
Street Address *
City *
State *
Zip Code *
Home Phone Number *
Work Phone Number
Cell Phone Number *
Email Address *
Profession *
Have you ever been convicted of a crime? *
If answered "yes" to above, please explain the circumstances
Date of Birth *
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DD
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Pet's name you are interested in adopting *
Do you *
Is the dwelling a *
Does your landlord allow you to have pets? *
Name of Landlord and phone number "if renting"
How long have you lived at your residence? *
Are you planning on moving in the next 6 months? *
If answered "yes" to above, please explain what you plan to do with your pet(s)
How many people live in your household? *
Please list names and ages of adults in the household: *
What are the ages of any children? (if children are present)
Is anyone allergic to animals? *
Are all people in your household aware you are adopting a pet? *
Is the cat you are planning to adopt going to be a gift for someone? *
Why do you want to adopt this pet? *
Have you adopted a pet from OMHS before? *
If yes, what happened to the pet?
Have you ever surrendered an animal to the humane society or rehomed a pet? *
If yes, please explain why.
Do you currently have a veterinarian clinic you plan to utilize? *
If yes, please list the clinic you plan to utilize and the phone number.
Please list the animals that you have owned in the past 5 years and include the following information: 
Name, Breed, Age, Spayed/Neutered, current on vaccinations "Y/N", the veterinary clinic(s) utilized, and what happened to your pet.
 *
Are all the animals you have now up to date on their rabies and distemper vaccination? *
Are you considering declawing your new cat? *
If yes or maybe, what are your reasons?
Are you prepared to assume the financial responsibilities of providing your cat with adequate food, litter, medical care, etc?

 *
Approximately how much do you anticipate on spending yearly on all cat supplies (food, litter, toys, etc) and medical care? *
Will this cat be an indoor cat? *
Will this cat be allowed outside? *
How often will you clean the litter box? *
Which best describes the time you are home? *
When you are not home, the cat will be *
What is the activity level of your household? *
What is your past experience with cats? *
Are you aware of the vaccinations and licenses required by law? *
Are you aware of any ordinances in your county/township concerning companion animals? *
Have any present or former pets bitten another person/animal? *
If yes, what action was taken?
What type of food do you intend to feed your cat? *
How often will you feed your cat? (i.e. twice daily, once daily, free feed) *
It may take your new cat 2-3 months or longer to adjust to its new home. Are you prepared to allow this much time? *
What are habits that you consider as ideal habits of a cat? *
What are habits that you cannot tolerate from a cat? *
Are there any behaviors that would cause you to return a cat after adoption? *
How did you hear about our adoption program? *
Please list two personal references that are not related to you nor live in the same household. Include their name, phone number, and best time to contact them. *
I recognize that by filling out this application I am not automatically approved for adoption and am not guaranteed the cat I have applied for.  *
Required
I certify that I have provided information that is accurate (to the best of my knowledge) and if information was falsified or not provided (i.e. landlord contact information) my application will not be considered.  *
Required
Is there any other information you would like to share or make us aware of?
A copy of your responses will be emailed to the address you provided.
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