Cat Adoption Application
We want to get to know you! Please fill out this preliminary application. An adoption Counselor will contact you. Please call 530-343-7917 X164
What cat(s) are you interested in adopting? *
Your Name *
Phone Number *
Home Address *
Current City, State & Zip Code *
Email Address *
Additional Owners and/or Emergency Contact Name *
Emergency Contact Phone Number *
How many adults live in the home? *
How many children live in the home? *
How will you introduce and acclimate your new cat to children? (If applicable) *
Are you... *
Do you... *
Your home is a.... *
If you Rent, does your landlord allow pets? *
If YES, how many pets are allowed (N/A if not renting) *
Manager Phone Number (N/A if not renting) *
Name of Landlord / Complex/ Park (N/A if not renting) *
Amount of landlord's pet deposit? If any, has it been paid? (N/A if not renting) *
How many pets live in your home? *
Please list the pets currently living in your home. Please include the type of animal and age. *
Are your pets up to date on vaccines? *
What animals have you owned in the past? *
Required
What are you looking for in a new cat? *
My new cat needs to get along with other cats *
My new cat needs to get along with dogs *
I'm looking for a cat that is... (check all that apply) *
Required
Check any of the following reasons for adopting this cat *
Required
Is everyone in the home in favor of adopting a new pet? *
Who will be responsible for daily care of your new cat? *
Required
Will this cat live... *
Required
Do any of your pets spends time outdoors? if YES, why? *
Are any members of your household allergic to cats? *
Veterinarian's Name and Phone Number: *
How much do you expect to spend annually on vet care for your cat? *
If your cat develops a medical problem , what would you do? *
Have any of your current or past cats been declawed? *
Will you declaw your new cat? *
How would you handle training if your cat has issues using the litter box? *
How will you handle training if your cat has scratching and or destruction issues? *
For which reasons below would you surrender a cat? Check all that apply... *
Required
Are you prepared to provide a permanent loving home for this cat for 15 years or more? *
Required
By signing below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of the rescue cat and possible removal of said cat from my home. I consent to Butte Humane Society representatives discussing information on this application with any persons named on this application. Applicants must be 18 years of age or older.

Butte Humane Society reserves the right to refuse any applicant for any reason. All completed applications become property of Butte Humane Society.
Your name (First and Last) *
Date Signed *
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