Full Name:

Address:

City: State: Zip:

Phone:

Email:

Please give us the description or type of cat that you are looking for.

Will this be your first companion cat?   Yes     No

What kind(s) of companion animals do you have now?

Have they been spayed or neutered?   Yes    No   Unknown

Will your present animals adjust to a new cat in the house?   Yes   No   Unsure  

How many adults are there in your household?  

How many children?   Children's ages:

Does any household member have an allergy to cats?   Yes   No

Do you live in a:   House   Apartment   Mobile home   Other

If you rent, do you have permission for this cat to live in your home?   Yes   No

Who is your veterinarian?  

Veterinarian's city or town:  

Please list a non-family personal reference (with phone number):

Note: By submitting this Adoption Application, you are testifying that it is true and factual. West Michigan SPCA reserves the right to reject any applicant for any reason at any time.