Middleburg Heights Animal Foundation

Adoption Application for Cats & Kittens

Today's Date:

Full Name:

Street Address:

City, State, Zip Code:

E-mail:

Phone Number:

Best Time to Call:

Name of pet you are interested in adopting:

What do you like about this specific pet?

How many adults are in your household?

How many children are in your household?

Please list the ages of the children in your household:

Other frequent visitors

Do you currently have any pets?
  Yes
  No

If you answered yes above, please explain?

Please list all of the animals that you have owned in the past 10 years (species and age) and where they are now.

I would consider my household to be like:
  A library
  Middle of the road
  A carnival

I am comfortable with a cat that likes to play "chase my ankles" and similar games:
  No
  Somewhat
  Yes

I want my cat to interact with guests that come to my house:
  Little of the time
  Some of the time
  All of the time
  It's not important if my cat interacts with guests

How do you feel about a boisterous cat that gets into everything?
  Love them but rather not live with them
  Depends on the situation
  Fine by me

My cat needs to be able to adjust to new situations quickly:
  Not important
  Somewhat
  Yes

I want my cat to love being with children in my home:
  It's not important whether my cat loves being with children
  Some of the time
  Most of the time
  Children do not often come to my house

My cat needs to be able to be alone:
  More than 9 hours per day
  4 to 8 hours per day
  Less than 4 hours per day

When I am at home, I want my cat to be by my side or in my lap:
  Little of the time
  Some of the time
  All of the time

I want my cat to enjoy being held:
  Little of the time
  Some of the time
  Most of the time

I need my cat to get along with (mark all that apply):
  Dogs
  Cats
  Birds
  Other:    Explain:

My cat will be:
  Inside
  Inside and Outside
  Outside

I have lived with cats before:
  Yes
  No
If yes, when:
  Currently

I prefer my cat to be talkative:
  No
  Yes
  It's not important if my cat is talkative

I want my cat to play with toys:
  Little of the time
  Sometimes
  Often

I want my cat to be active:
  Not very active at all
  Somewhat
  Yes, very

The most important thing for me is that my cat

Do you currently...?
  Own
  Rent
If renting, please provide the following...
Landlord's Name:

Landlord's Phone Number:

Are you planning any major life changes in the next 5 years (marriage, moving, pregnancy, etc.)?

Is any member of your household allergic to pets?
  Yes
  No
If yes, what type of allergies?

Are there any reasons why you would give up a pet?

Are there behaviors that you would have a hard time dealing with? How would you handle these problems?

Any additional information you would like us to consider in reviewing your application. If you want us to hold this pet for any additional amount of time, etc. please indicate so here.

Who is your family veterinarian or veterinary clinic?

Vet's Phone Number:

How did you hear about MHAF?

I, the undersigned, do hereby release Middleburg Heights Animal Foundation, its directors, officers, trustees, volunteers and representatives from liability to myself and/or my party for any damage, accident, or injury to person(s) or property incurred in relation to viewing of the animals under the control of the organization.

I hearby affirm that all of the above information is true and correct. I understand that submission of this application does not necessarily mean that I will be approved to adopt and Middleburg Heights Animal Foundation reserves the right to reject any applicant. I authorize MHAF to verify any and all information set forth in this application. (Without your electronic signature we cannot process this application).

Signature:

By typing your name in the signature box above you certify that the information included in this application is true and accurate to the best of your knowledge and that you are the individual requesting to be approved for the adoption of a pet currently in the care of Middleburg Heights Animal Foundation and its foster homes.