Two Left Paws Cat Adoption Application
Personal Information
Where did you hear about Two Left Paws Animal Sanctuary?
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Sheboygan Pet Supplies Plus
Sheboygan PetSmart
Sheboygan K-Mart
Plymouth K-Mart
Manitowoc PetCo
Grafton The Feed Bag Pet Supply
Saukville Pet Supply Port
West Bend PetCo
Saw a Poster
Newspaper
Other
What is the name of the cat you are applying for?
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Please list all names if applying for more than one cat
Where did you meet the cat you are applying for?
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Please select...
Sheboygan Pet Supplies Plus
Sheboygan Petsmart
Manitowoc PetCo
West Bend PetCo
Grafton The Feed Bag Pet Supply
Saukville Pet Supply Port
Other
Have Not Met Animal
If you answered other, please explain:
Your name
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Last, First, MI
Your date of birth
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xx/xx/xxxx
Your spouse/significant other name
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Last, First, MI
Your spouse/significant other date of birth
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xx/xx/xxxx
Home address
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What type of residence do you live in?
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Please select...
Own House
Rent House
Rent Apartment
Live with parents or other
If renting or leasing, list landlord name and phone number(s):
How long have you lived at this address?
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Please give your previous address if less than two years:
Do you plan to move in the near future?
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Yes
No
Please list the names and ages of other members in the household, not listed, including adults and children:
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If there are no other residence in your household, type "None"
Home phone number
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xxx-xxx-xxxx
Cell phone number
xxx-xxx-xxxx
E-mail address
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Do you or others in your home have allergies or asthma? Please explain:
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Pet Care Questions
Why do you want a cat?
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Companion
Gift
Breeding
Protection
Hunting
For Child
Companion for Pet
Check all that apply
Are all members of the household 'on board' with and excited about adopting a pet?
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Yes
No
How long will your pet be left alone, without human companionship, each day?
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Are you willing to be patient and take time to allow your new pet to adjust to you and your home?
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Yes
No
Are you financially able to provide annual and routine per care (exams/vaccinations)?
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Yes
No
Are you able to make a LONG-TERM committment to care for a pet?
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Yes
No
Pets can live 10-20 years!
Will you be able to live with pet hair on your furniture/clothes, stains on your rugs, a warm body in your bed, or an animal that could be destructive at times?
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Yes
No
Are you able to provide proper grooming/shelter/exercise and a quality diet for your new pet?
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Yes
No
Please talk with your Veterinarian about proper nutrition for your pet
What would happen to this pet if you moved due to job change/lifestyle change/relationship change/etc.?
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Who will care for your pet(s) when you take trips?
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Under what circumstances would you not be able to keep this pet?
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What would you do if you were unable to keep this pet?
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Where will the cat be kept when left alone?
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What areas of the house will the cat be allowed into?
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Will your cat be let outdoors?
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Yes
No
Will your cat be harnessed or on a leash when let outside?
Yes
No
Do you want your cat to have kittens?
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Yes
No
Some cats will 'spray' (mark territory with urine) in their homes, are you willing to deal with that?
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Yes
No
Do you plan on declawing your cat?
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Yes
No
If "Yes", which paws do you plan on declawing?
Front
Back
All Four
For what reasons do you plan to declaw?
Is declawing a requirement of your lease if renting?
Are you familiar with how declawing surgery is performed?
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Yes
No
Would you like information on alternatives to declawing?
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Yes
No
Current Pet Information
Please list all pets currently living in your home:
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List Name, Breed, Age, Sex. If you currently don't have any pets, please type "None"
Are all pets currently living in your home spayed and/or neutered?
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Yes
No
Doesn't Apply
If you answered No to the above, please list reason(s) why animals are not altered:
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If you answered Yes or Doesn't Apply, please type "N/A"
Please list pets you have OWNED IN THE PAST:
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List Names, Ages, Breed, Sex, and if Spayed/Neutered. Type "None" if you have not had pets before
Please list what became of the pets you have owned in the past that are no longer in your care:
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If you have never owned a pet, please type "N/A"
Please list past and/or present Veterinarians used:
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List Name of Office/Clinic. If you have never used a Veterinarian, type "None".
Vet's Phone Number
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Please typ "N/A" if you do not currently have a Veterinarian
List names (including maiden) that pets above may be listed under:
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If this does not apply to you, type "None"
May we contact your veterinarian for a reference?
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Yes
No
Doesn't Apply
Miscellaneous
Please list any comments you feel you would like to share:
Will you allow a Two Left Paws representative to visit your home PRIOR to adoption?
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Yes
No
Will You allow a Two Left Paws representative to visit your home AFTER adoption?
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Yes
No
Application completion DOES NOT mean you are guaranteed adoption approval!! By entering my name below, I certify that the information I have given is true and I recognize that any misrepresentation of the facts may result in my losing the privelege of adopting a pet. I understand that Two Left Paws Animal Sanctuary has the right to deny my request to adopt an animal and I aurthorize investigation of all statements in this application, including any veterinary records.
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Type Name and Current Date
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