Regional Animal Protection Society

Basic Information

Questionnaire

Final steps

Basic Information

Please fill out your contact information

Date of Application

Cat's Name

Has everyone in the household met this cat?

Yes

If yes, where did you meet this cat?

Your Name Hereinafter referred to as the 'Adopter'

Home Phone

Cell Number

Your Address

City

Province

Postal Code

Your Email

Personal Reference Name (not a family member)

Reference Phone Number

Relationship to You

How long have you known each other?

Questionnaire

Please complete the following questionnaire in its entirety. Our main objective is to ensure good compatibility between you, your family, and your new pet.

Do you own or rent your residence?

Own

Rent

If you rent, do you have your landlord's permission to have a cat?

Yes

Landlord's Name & Phone Number

What type of home do you live in?

House

Apartment

Condo

Trailer

Townhouse

Other

If you answered other, please explain

How long have you resided at your current address?

Less than 1 year

1-2 years

3-5 years

5-10 years

10+ years

Is this going to be your first cat?

Yes

If this is not your first cat, where did your previous cat reside?

Indoor

Outdoor

Indoor & Outdoor

Where will THIS cat be residing?

Indoor

Outdoor

Indoor & Outdoor

If this is not your first cat, what happened to your previous cat?

What energy level are you looking for in your cat?

Low

Medium

High

List plans for this cat

Companion

Company for other pet

Barn cat (mouser)

Other

If you selected other, please describe

Do you have a regular veterinarian?

Yes

If yes, please provide vet's name and phone number

Are you 19 years of age or over?

Yes

Who will be the primary caregiver of the cat?

What is your occupation?

Do you have reliable transportation?

Yes

Are all family members in agreement about adopting a cat?

Yes

How many people reside in your home?

Are there any children residing in your household?

Yes

If yes, how many children?

What ages are the children?

Does any family member suffer from allergies?

Yes

If yes, what type of allergy?

Do you currently have any animals in your care?

Yes

If yes, please list the animals, along with their name and age:

Are they spayed or neutered?

Yes

If you do have any pets, how do you feel they will adjust to a new cat in the house?

Where will this cat spend the day when you are home?

Loose indoors

Loose outdoors

Basement

Garage

Barn

Other

If other, please describe

Where will the cat spend the day when you are NOT home?

Loose Indoors

Loose outdoors

Basement

Garage

Barn

Other

If other, please describe

Where will this cat spend the night?

Loose indoors

Loose outdoors

Basement

Garage

Barn

Other

If other, please describe

How long will the cat be alone most days?

Where will the cat go when you are away or on vacation?

Do you feel you can commit to a cat for the next 10 to 20 years?

Yes

How much do you expect the cost of cat ownership to be monthly for everyday supplies? (ie. food, litter, enrichment, etc.)

Have you in the past or would you ever consider declawing your cat?

Yes

If you were to move in the future, what will happen to the cat?

Are you able to provide proper medical care for your cat as required?

Yes

How much can you afford annually for vet care?

Have you ever surrendered or rehomed an animal?

Yes

What would prompt you to surrender an animal?

Do you agree to return the cat to RAPS if you can no longer keep it?

Yes

If your cat scratched up your couch, how would you handle this?

If you returned home to find your cat had urinated/defecated outside the litter box (floor, couch, bed, etc.), what would you do?

If it was an unusual behaviour what would you do?

If it was an ongoing behaviour what would you do?

Final steps

Only applicants chosen for adoption will be contacted. RAPS reserves the right to refuse any applicant.

Animal Control Services are concerned for the well being of all shelter cats. Would you be willing to allow one of our staff members to do a scheduled home visit prior to, and/or after the adoption process?

Yes

If no, please explain

I certify that all the information I have provided is true and correct

Yes