First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

PERSONAL INFORMATION

What is the best time to call you? Keep in mind our Volunteers call from their own phones, so you may not recognize the caller ID.*

What is your age? *

Please name any second party in the adoption.

Please identify how many children live in the home with you as well as their ages.

Please provide the total number of adults living in your home.

CURRENT PETS

Please list current pets ( cats/dogs only).  Include the following information in the boxes below for EACH animal.  ( If you do not currently have a cat or dog, please enter "Not Applicable") .     

Pet #1 NAME, SPECIES (Dog or Cat), AGE, STERILIZED, CURRENT ON VACCINATIONS? INSIDE or OUTSIDE animal?*

Pet #2 NAME, SPECIES (Dog or Cat), AGE, STERILIZED, CURRENT ON VACCINATIONS? INSIDE or OUTSIDE animal?

Pet #3 NAME, SPECIES (Dog or Cat), AGE, STERILIZED, CURRENT ON VACCINATIONS? INSIDE or OUTSIDE animal?

Pet #4 NAME, SPECIES (Dog or Cat), AGE, STERILIZED, CURRENT ON VACCINATIONS? INSIDE or OUTSIDE animal?

Please list any cats/dogs in the home NOT owned by the primary applicant.

Do you have a veterinarian? *
Choose one: No Yes

If yes, please provide your vet's NAME and PHONE number. ALSO, call your vet to give them permission to speak with us.

PAST PETS

If you currently have NO pets, please list any that you've had in the past 3 years.  Include the following information in the boxes below for EACH animal.   If you have never had a cat or dog, please enter, "Not Applicable".  

Pet #1 NAME, SPECIES (Dog or Cat), AGE, WHAT HAPPENED to the animal?

Pet #2 NAME, SPECIES (Dog or Cat), AGE, WHAT HAPPENED to the animal?

DESIRED CAT

Please select the cat you are interested in adopting below. If you have not yet decided, just leave this blank.
Choose an animal: Albus Alec (MUST BE ADOPTED WITH VIKTOR) Bandit (MUST BE ADOPTED WITH PIETER) Cabby Caliana Captain - BONDED WITH SARGE Catori Chrissy Dezee Dobby Dolly Parton Doozee Drax Farah (MUST BE ADOPTED WITH WASABI) Friday (Bonded with Inkster) Gale Gamora Indigoe Inkster (Bonded with Friday) Koga Ladybug Lea Lol (means Joy) London (MUST BE ADOPTED WITH LOUISA) Louisa (MUST OF ADOPTED WITH LONDON) Lujayn Magic Mew Millie Mushu Mystery Nebula Nuo (means Graceful) Pastel Petosky Pieter (MUST BE ADOPTED WITH BANDIT) Polly Pongo - MUST BE ADOPTED WITH ROGER Ralphie - MUST BE ADOPTED WITH REMINGTON (must be adopted with Remington - MUST BE ADOPTED WITH RALPHIE) Remington - MUST BE ADOPTED WITH RALPHIE (must be adopted with Ralphie - MUST BE ADOPTED WITH REMINGTON) Roger - MUST BE ADOPTED WITH PONGO Ruth Salem Sarabi Sarge- BONDED WITH CAPTAIN Shika Tequila(aka Tallulah) Thursten Tiffani Velvet Veronica Vienna Viktor (MUST BE ADOPTED WITH ALEC) Wasabi (MUST BE ADOPTED WITH FARAH) Wonder Yandu

If you do not see your desired cat's name in the above question, but have seen them shown on our Facebook page, please enter any details you have that will help us identify the cat you want.

If your desired cat has already been adopted, please list a 2nd and 3rd choice. You can find all of our currently available cat/kittens on our website (locrami.com)

How many hours will your new cat be alone during the day?*

Please let us know what your ideal cat would be like in the space below: *

Do you prefer a male or female? *
Choose one: Male Female No preference

Please identify what hair length you prefer:*
Choose one: Long hair Medium hair Short hair No preference

Please identify any other animals your cat must get along with. Please select all that apply (to select multiple options, press the "Ctrl" key while selecting multiple items).
Choose all that apply: Cat(s) Dog(s) Other animal type Not applicable, no other animals

Do you plan on declawing?*
Choose one: Front Paws Back Paws All Paws Not Declawing

Please provide a digital signature in the text box by typing your full NAME and DATE below.*