Cocheco Valley Humane Society
Cat Adoption Information Request

Note: This Info will be forwarded by Email to the Cocheco Valley Humane Society

Which cat are you
interested in adopting?:
Your Name:
Maiden Name:
Date of Birth:
Spouse Name:
Spouse DOB:
Zip Code:
Home Phone:
Work Phone:
Do you Please Select One Own Your Home? Rent A House? Rent An Apartment? Own A Mobile Home In A Mobile Home Park? Own A Mobile Home On Owned Land?
If you rent - Landlord's Name and phone:
How long at current address?:
If less than one year, please show previous address:
Are you: (Check all that apply)
Working   Retired   Attending School   Homemaker   Other
Your Employer:
Employer Phone:
Spouse/Partner's Employer:
Spouse/Partner's Employer's Phone:

E-mail Address:
Please be sure to include your entire e-mail address, including the "@" and ".com", ".net", etc.

Pets You've Owned in the Past Five Years

Name Breed/Type Age Sex Altered Still Own Kept Where If no, what happened to this pet?
Who has been your veterinarian?

My Preferences

I like cats who are: (Check all that apply)
Short Hair   Medium Hair   Long Hair   Declawed   Any
I prefer a: 
Please describe the temperament and activity level you are looking for in a cat. (Check all that apply):
Zippy, high-energy, kitten-like   Mellow, easy-going   A lap cat  
Independent   Very Affectionate   Responsive   Talkative   Quiet
Someone in my home is nervous or unsure of cats:  (Check all that apply)
Very Unsure Moderately Unsure Some (no experience with cats) N/A

About Me and My Household

I share my home with adults and children.
Ages of children:
I have children that visit or live next door.
I have indoor cats(s), in/out cat(s), dog(s), and these other pets and livestock:
The noise/activity level in my home is usually:
Please Select One Low Medium High
When it comes to keeping a clean and tidy house, I am:
Please Select One Very Particular Particular Easygoing
I need a cat that will tolerate being alone hours a day.
Weekends For Frequent Short Trips
I'd enjoy brushing or grooming my cat:
Please Select One Rarely Occasionally Weekly Daily


I prefer a cat whose energy level is:
Please Select One Low Medium High
I prefer a cat that:
will enjoy living indoors.
will enjoy being outside while I'm with him/her.
will come and go independently.
will enjoy living in our barn.


My ideal cat would:
Bad kitty habits that I just can't tolerate are:

It can take a new pet up to 2 months to adjust to a new home. Are you willing to devote this time? 
Please tell us anything else you would like us to know about you or the cat you're looking for:
Please list two personal references:

Please check any areas you would like to discuss with an adoption counselor:
What to feed your cat and how often
Introducing your new cat to other pets
Introducing your new cat to children and other family members
Litterbox Training


How will you handle the following?

Where will you keep your cat during the day, at night, or when you're not home?:

If you have to move?:

How will you care for your pet when you're on vacation or business trips?:

How will you handle bad habits such as marking, jumping on counters or furniture, nipping, scratching, scatching furniture, eating plants?:

  Please only click once.
By filling in your name and the date, and submitting below, you certify that: "The information I have given is true, and I authorize CVHS to contact veterinarians, landlords, and references to investigate all statements in the application, and to do follow-up property checks."

After clicking "Send Info" you will need to click "OK" then "Send".