Humane Society Of Somerset County, Inc.
P.O. Box # 493
Princess Anne, Md. 21853
410 - 651 - 2424
www.humanesocietyofsomersetcounty.org
Adoption Application For Cats and Kittens
Date: ____________________________
Name: __________________________________________
Address: ________________________________________
City: ________________________________________
State: ____________________________
Phone ( home ) ________________________( Cell: ) __________________________
( Work : ) ________________________ OK to call you at work ? Yes _____ No _______
1. Why do you want to adopt this cat / kitten ? ___________________________________
2. Have you owned, or do you own any pets ? Yes ____ No _____
3. If yes, how many pets do you currently own ? Cats _____ Dogs ______ Other _______
4. What are their names ? ____________________________________________________
5. Are they spayed or neutered ? Yes ____ No ____ If No, why not ? _________________
6, Who is your Veterinarian ? _________________________Phone ___________________
7. Are there children at home ? No _____ Yes ____ What are their ages ? ___________
8. Do you rent or own your own home, apartment or other ? __________________________
9. If you rent, we will need your landlord's permission in writing, or a copy of your lease in regard
to owning pets.
10. Where will this cat / kitten sleep ? ____________________________________________
11. Are you looking for a particular breed of cat ? Yes ____ No _____
12. Are you considering adopting a particular cat / kitten ? If so, who ? __________________
13. Where did you see this cat / kitten ? Website _________ Petfinder.com _____________
Adoption event ______ Cage at Vet's or Ace Hardware ? __________ Newspaper ? _____
14. Would you consider adopting an older cat, or a cat with special needs ? Yes ____ No ___
A mixed breed cat or kitten ? Yes _____ No _____
15. Are other members of the household aware that you are considering adopting a cat / kitten ?
Yes ____ No ____
16. Can you assume the financial responsibility of owning an animal, including Vaccinations, vet
care and good quality food ? Yes ____ No ____
17. Please give an estimate of yearly costs for FOOD ________ MEDICAL __________
18. Are you planning to move in the near future ? Yes _____ No ______
19. Are you familiar with any animal regulations in your area, including Homeowner Association
rules and landlord rules that may apply ? Yes _____ No_____
Click Here For Next Page