Date
*
MM
DD
YYYY
Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date of Birth
MM
DD
YYYY
Home phone
*
(###)
###
####
Cell phone
*
(###)
###
####
List your occupation, employer, years at address. If unemployed or a student, detail how you plan to provide for a cat
*
How many people are in your household? List their ages.
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How many children live in your household? What are their ages?
*
Do you live in a house, apartment, condo, townhome, duplex?
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How long have you been at this address?
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Do you own or rent your home?
*
Own
Rent
If renting, are there any pet restrictions?
Yes
No
If yes, what are they?
Have you or anyone in your home ever been charged or convicted of animal abuse, cruelty, or neglect?
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Yes
No
Have the police ever been called to your residence for domestic violence?
*
Yes
No
Do you currently have pets?
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Yes
No
If yes, what kind?
Please check all that apply
Dogs
Cats
Other
How long have you had each current pet?
Are they spayed/neutered?
Yes
No
If spayed/neutered, which veterinarian do you currently use?
Who will have primary responsibility for this cat's daily care?
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Who will have financial responsibility for this cat?
*
Do you agree to provide regular health care by a licensed veterinarian?
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Yes
No
How will you discipline your cat?
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If behavioral issues arise, are you willing to work with a professional trainer?
*
Yes
No
Cats need preparation training for life changes such as having a baby, moving, divorce, etc. Are you committed to working through these changes?
*
Yes
No
How much quality time can you offer your cat, and what type?
*
How many hours during the day will the cat spend without a human?
*
Where will the cat be when someone is home?
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Where will the cat be when alone?
*
Where will the cat sleep?
*
What situations do you feel unprepared for?
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Check all that apply
None
Digging
Shy, fearful, under-socialized
Not good with small animals
Needs to be the only cat
Destructive chewing/scratching
High activity level
Not good with kids
Not housebroken
Resource, toy, food guarding
Deaf, blind
Administering medication
Is there a specific Zion's Mission cat that you are interested in?
Please tell us anything else you'd like us to know.
Please list two references.
*
Include name, address, phone number