Is the address listed the same as where your new pet will reside? *
Home Phone Number *
Your answer
Cell Phone Number *
Your answer
Living Status *
Choose
Married
Single
Roommate
Companion
Name of spouse,roommate or companion?
Your answer
Living Situation *
Choose
Own
Rent
Live with family
Age *
Choose
21-40
41-60
61-75
76+
Occupation *
Your answer
Name of Employer *
Your answer
Employer Address *
Your answer
Employer Phone Number *
Your answer
Do you expect to move within the next year? *
If Yes, what will be your new address?
Your answer
Type of Housing *
Choose
House
Apartment
Condo
Townhouse
Other
Are you permitted to keep pets in your house, apartment, condo, etc? *
Landlord's Name
Your answer
Landlord's Phone Number
Your answer
If you own a condo/townhouse, what is your management company's name.
Your answer
Management Company's Phone Number
Your answer
How long have you lived at your current address?
Your answer
How many adults live at your current address?
Your answer
How many children and their ages live at your current address?
Your answer
Are all members of the household aware of, and in agreement with owning a cat? *
Have you ever applied to adopt an animal before? *
Is this your first time experience with a cat? *
Is this pet a gift? *
If yes, who is the gift for?
Your answer
Which member of the household will feed the cat and keep the litter box clean? *
Your answer
What is the reason you want a cat/kitten? *
Your answer
If something should suddenly happen to you have you made arrangements/provisions for the care of your pet for the rest of its life? *
Who would be caring for your animals in your absence? *
Your answer
Are there any persons with pet allergies living in the household? *
Have you ever taken one of your animals to a shelter? *
If yes, please describe circumstances
Your answer
Veterinarian's Name
Your answer
Veterinarian's Address *
Your answer
Veterinarian's Phone Number *
Your answer
What name are your pet's record listed under? *
Your answer
If you have pets, please list them all, including their breed, age, sex, spayed or neutered, licensed, and if up to date on vaccinations.
Your answer
If you have cats in your household have they been tested for FIV/FELV? *
What do you think the normal life span of a cat is? *
Your answer
What are your feelings on declawing? *
Your answer
Where will your cat/kitten be staying? *
Do all adults work full time? *
Approximately how long will your new pet be alone during the day? *
Your answer
Will you allow a START representative to visit your home? *
Do you agree to return the cat to S.T.A.R.T. if at any time you can no longer keep the cat? *
If your adopted animal does not work out in your household, you agree to contact S.T.A.R.T. immediately? *
In the event your adopted animal needs to be returned, do you agree to give S.T.A.R.T. sufficient time to coordinate foster care or allow S.T.A.R.T. to provide resources to help you re-home the pet prior to returning. *
Please provide 3 personal references, not living with or related to you. Provide full name, phone number, and relation to you. *
Your answer
Do you understand that S.T.A.R.T. reserves the right to contact persons listed above? *
Sterilizing and Micro-chipping are part of our adoption program. They are included in your adoption fee. If not already done so by S.T.A.R.T., do you agree to have your new pet spay/neutered and micro-chipped according to S.T.A.R.T.’s terms, requirements and stipulations? *
Have you or anyone in your household ever been charged with animal cruelty? *
If yes, explain.
Your answer
Are you aware of and agree to S.T.A.R.T.'s non-refundable adoption fee? *
Do you certify that the information collected above is complete and correct to the best of your knowledge? *
Thank you for completing this form. After its review, a volunteer will contact you. If you have any additional comments, let us know here.