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 answer
Your Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Home Address (Street/City/State/ZIP) *
Your answer
Emergency Contact for Microchip (other than yourself) *
Your answer
Do you... *
Your home is a.... *
If you Rent, does your landlord allow pets?
If YES, how many pets are allowed
Your answer
Amount of pet deposit? If any, has it been paid?
Your answer
Name of Landlord / Complex/ Park
Your answer
Manager Phone Number
Your answer
How many adults live in the home? *
Your answer
How many children? Ages? *
Your answer
Are any members of your household allergic to cats? *
How will you handle the interaction between the new cat and your children?
Are you... *
How many pets live in the home? *
Please list the pets currently living in your home (Type/Age/Spayed and Neutered? Current of Vaccines?) *
Your answer
Please List any other pets you have previously owned as an adult (Type/Age/How long did you own? What happened?) *
Your answer
Veterinarian's Name and Phone Number: *
Your answer
What are you looking for in a new cat?
I'm looking for a cat that is... (check all that apply)
Check any of the following reasons for adopting this cat
Will this cat be a surprise for anyone? Who? *
Your answer
Is everyone in the home in favor of adopting a new pet? *
Who will be responsible for daily care of your new cat? *
How much do you expect to spend annually on vet care for your cat? *
If your cat develops an expensive medical problem , what would you do? *
Your answer
Have any of your current or past cats been declawed? *
Will you declaw your new cat? *
What percentage of time will the cat live indoors? *
Your answer
Do any of your pets spends time outdoors? if YES, why?
Your answer
How will you handle litter box problems? *
Your answer
How will you handle scratching and or destruction issues? *
Your answer
Which circumstances justify giving up 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) *
Your answer
Date Signed *
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