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.

Do you or anyone in your household have allergies or sensitivities to cats?*
Choose one: Yes No Unknown

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: Apricot Bergamo (polydactyl) Blaze (MUST BE ADOPTED WITH BUMPER) Blizzard (MUST BE ADOPTED WITH FROSTY) Bluesy Bree (Bonded w/Theo) Bumper (MUST BE ADOPTED WITH BLAZE) Coach Comet ( MUST BE ADOPTED WITH COSMO) Cosmo (MUST BE ADOPTED WITH COMET) DJ Dott Elyjah(BONDED WITH LOUCAS) Emma Esmeralda Figgy Pudding Flash Francine ( Frosya) (MUST BE ADOPTED WITH MOOCHIE) Frosty (MUST BE ADOPTED WITH BLIZZARD) Goldie Hawn (MUST BE ADOPTED WITH KATE HUDSON) (must be adopted with Kate Hudson (MUST ME ADOPTED WITH GOLDIE HAWN) and Kate Hudson (MUST ME ADOPTED WITH GOLDIE HAWN)) Half-C Helen Jagger Kate Hudson (MUST ME ADOPTED WITH GOLDIE HAWN) (must be adopted with Goldie Hawn (MUST BE ADOPTED WITH KATE HUDSON) and Goldie Hawn (MUST BE ADOPTED WITH KATE HUDSON)) Kattie Kiwii Kloee (must be adopted with Nena and Nena) Little Baby Loco Loucas(BONDED WITH ELYJAH) Millie Monique Moochie (MUST BE ADOPTED WITH FRANCINE) Otto Peppermint Patty Petunia Sasha Sassy Molly Smokie (must be adopted with Sonny) Sonny (must be adopted with Smokie) Spunky Sunny Teo Theo. (Bonded w/Bree) Toshiko

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

CURRENT PETS

Please list current pets ( cats/dogs only). Include the following information in the box below for EACH animal: NAME, SPECIES (Dog or Cat), AGE, STERILIZED, CURRENT ON VACCINATIONS? INSIDE or OUTSIDE animal? ( If you do not currently have a cat or dog, please enter "Not Applicable") . *

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

Have you ever had to rehome an animal? If yes, why?*

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

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

PAST 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".  

Please list past pets (cats and dogs) NAME, SPECIES (Dog or Cat), AGE, WHAT HAPPENED to the animal?

ADDITIONAL INFORMATION

Do you own or rent your home (choose one)?*
Choose one: Own Rent

Does your Landlord or City have any restrictions on having cats, and if so, what are they?

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

Would your cat stay inside, outside or both inside and outside.*
Choose one: inside outside inside and outside

What would you do if your cat accidentally got outside?*

If something were to happen to you and you were unable to care for your pet, who will assume responsibility?*

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