Your Name:

Your mailing address:

Phone number:

Email address:

Have you adopted with us in the past? Yes No
If yes, when (month/year) and who?

How did you hear about Crash's Landing?

HOMELIFE

Number of adults in household?

Children? Ages?

Roommates? Yes No

Do all of the adults in the household know you plan to adopt a cat? Yes No

Have your children lived with cats previously? Yes No

Is anyone in your household allergic to cats? Yes No

If yes, how do you plan to address the allergy?

Household activity level: Quiet Active Very active

Do you own or rent your home? Own Rent
If you rent, do you have permission from your landlord to have a cat? Yes No
Landlord's name:
Landlord's number:

If you own a condo or townhome, can you provide written documentation (association by-laws) indicationg that pets are allowed? Own Rent

PET HISTORY

Have you owned a cat before? Yes No

Do you currently have pets? Yes No
If yes, tell us about your pets (name, type, age, spayed/neutered, length of time in your family)

Will the cat live: Indoors only? Outdoors only? Indoors and outdoors? Not sure

Where will the cat be when nobody is home? Indoors Outdoors Either indoors or outdoors?

Current veterinarian: name, clinic name, phone number

Under whose name and what address are records kept?

Are your pets current on vaccines? Yes No

How often do you plan to take your cat to the veterinarian?

How many litter boxes do you intend to have for your cat(s)?

Have you recently had a cat that did not use the litter box? Yes No

What did you do about the problem?

NEW PET

On the first night home, where will the cat stay? (be specific)

It may take a cat a month or longer, especially when other pets are involved, to adjust to its new home. How would you address this?

Are you committed to providing a home for this cat for the next 10 to 20 years? Yes No

What circumstances might justify giving up a cat? (check all that apply)
Baby
Moving
Shedding
Want to travel
Divorce
Allergies
Behavior problems
Cat becomes ill
Children lost interest
Cat not getting along with other pets
New household member dislikes cats
Not using litter box
DestructiveScratching
Too time consuming
None
Other  

If your new cat exhibits behavioral or adjustment issues, how will you address this?

What do you estimate will be the annual cost for caring for this pet?

Are you willing to provide, and can you afford, emergency care for this pet? Yes No

If you go away for a few days, or on vacation, who will take care of the cat?

What arrangements will you make for the care of your pets in case of emergency, or if you become unable to care for them?

If you move, will you take the cat with you? Yes No

REFERENCES

Please list three references (other than relatives) who know you as a pet owner.

• Name:
• Relationship:
• Phone number:
• Best time to call:

• Name:
• Type of reference:
• Phone number:
• Best time to call:

• Name:
• Type of reference:
• Phone number:
• Best time to call:

OUR CATS

If there are specific cats you wish to meet at Crash's or Big Sid's, please list them here. (You can, of course, visit with any of our cats.)

SUBMITTING YOUR APPLICATION

By clicking the Submit This Form button below, I certify that:

• The information I have given is accurate
• I understand that Crash's Landing has the right to deny any application
• I give permission for a representative of Crash's Landing to call the references and veterinary practice I have listed above