Mighty Mutts Help Sheet

Mighty Mutts Pre-Screening Adoption Application
for Cats

If you are interested in adopting one of our cats, please fill out and submit the following application. The following proceedure then follows.

If the application looks promising, you will receive a telephone call from a volunteer within one week of submission
Pending the result of the telephone interview, an in-home interview will be arranged at a time of mutual convenience
If an in-home interview is condicted, you will then be notified within 24 hrs. of the decision regarding your application

Please Note:
Mighty Mutts can not accept applications from outside the New York City/Tri-state area since we performs in-home interviews on all promising applicants.
Completion of this application, interview, and home visit do not guarantee adoption.

xxx

Name of the cat you are interested in adopting:
Date

PERSONAL CONTACT INFORMATION NAME: First: Last:
Gender: Male    Female
Age:
E-Mail:
Primary Telephone Number*: Area Code:   Number:
Alternate Telephone Number*: Area Code:   Number:
* Telephone number is required so that one of our screeners can contact you personally
Is your home phone telephone listed in your own name? Yes No
Your current address
Street:   Apt. Num:
City:   State:    Zip Code:
How long have you lived at your current address?
Do you: Own?    Rent?      Sublet?
If you rent, when does your lease expire?

BRIEFLY DESCRIBE YOUR RESIDENCE
Does the residence in which your pet will be living have: (please check all appropriate boxes)

Terrace: Balcony Yard Deck Porch Elevator

Fire Escape Washer/Dryer: Dishwasher

How many windows have screens?
How many windows do not have screens?
Have you confirmed that pets are allowed? Yes No I don't know
Your previous address
Street:   Apt. Num:
City:   State:    Zip Code:
How long did you live at your previous address?

WHY ARE YOU ADOPTING A CAT?
Why are you adopting a cat/kitten?

Are you adopting a cat for: Home Work Someone Else
What kind of cat are you interested in adopting?
Breed:
Age range:
Gender:
Short/long hair:
Diposition:

Do you a cat that is declawed? Yes No
Would you prefer a cat that can catch mice?   Yes No

BRIEFLY DESCRIBE YOUR LIFESTYLE
Do others live with you? YesNo
I yes, whom?

Do all members of your household wish to adopt a cat? Yes No
Does anyone in your home have allergies to animals? Yes No
When you travel will you take your cat(s) with you? Yes No
Will your adopted cat have access to the outside? Yes No
Who is your current employer?
Occupation:
Employer Phone: Area Code:   Number:
How long have you worked at this company?
How many hours per day do you work?
Does your job require travel? Yes No
If yes, how often?
Who was your previous employer?
How long did you work at this company?
Does your budget allow for the cost of maintaining a pet, and can you cope with vet expenses? Yes No
What would you estimate the cost of maintaining a pet to be per month? $
What type of cat food do you use?
Wet   Dry Mix I cook for my cat If you use commercial cat food, what brand is it?

WHAT IS YOUR PET EXPERIENCE?
Do you presently share your home with any animals?

cat(s) dog(s) other no pets

If other, what type?

If you have cats:

How many?

What breed(s)?

What gender(s)?

How old are they?Yrs /Mos

How long have you had them?   Yrs /Mos

Are they spayed/neutered? Yes No

Are they vaccinated? Yes No

Are they declawed? Yes   No

Has this/Have these/ cat(s) been screened for FiV/FelV? Yes No

If you have dogs:

How many?

What breed(s)?

What gender(s)?

How old are they?Yrs /Mos

How long have you had them?   Yrs /Mos

Are they spayed/neutered? Yes No

Are they vaccinated? Yes No

Have you ever owned a pet in the past? Yes No
If yes, which species?
Where is this pet now (please explain fully)?

What veterinarian, if any, are you either currently using or have used in the past?
Name of Veterinarian
Street:
City:   State:    Zip Code:
Telephone Number:   Area Code:   Number:
Were you ever in a situation where you were not able to keep a pet? Yes No
If yes, please explain fully:
Cats can often live to eighteen years of age or longer. How long will you be able to care for your cat?
Are you willing opposed to follow-up visits by an Mighty Mutts or Ollie’s Place representative?
Yes No
In case of emergency, who will care for your cats?
NAME: First: Last:
PHONE: Area Code:   Number:
May we call this person to verify? Yes No
In the event that you would no longer be able to care for this animal, what provisions would you make?

UNDER WHAT CIRCUMSTANCES WOULD YOU NOT BE ABLE TO KEEP THIS PET?
Check off all that apply.
Personal Changes

Divorce/separation New spouse Pregnancy/new baby New roommate

New allergy Job change Disability/Illness New house/apt

Change in lease/landlord
Behavior Problems

Too rough with kids Too rough with cats Doesn't get along with other pets

Keeps you awake ”Talks” too much Needs too much attention

Scratches carpets, furniture, etc. Sprays/does not use litter box

Health Problems

Cat incurs expensive vet bills Cat becomes disabled Cat needs special diet

Cat requires daily treatment (pills, shots)

Please describe any circumstances not checked above that would prevent you from keeping a cat:

PLEASE SUPPLY 1 BUSINESS AND 1 PERSONAL REFERNCE (REQUIRED). BUSINESS REFERENCE
NAME: First: Last:
PHONE: Area Code:   Number:
PERSONAL REFERENCE
NAME: First: Last:
PHONE: Area Code:   Number:

How did you find out about our adoption program?

I certify that the above information is true. I understand that completion of this application is not a guarantee of adoption through Mighty Mutts, Inc. YesNo