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Adoption Application
Cat
Tiny Dancer
Name:
Tiny Dancer
Description:
Female, 6 months old (DOB 4/29/2024), Domestic Short Hair, Black and White mostly White
(
Remove
)
New Home
Name:
First:
Last:
Address:
City:
State:
AA
AE
AK
AL
AP
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip:
Home phone:
Work phone:
Cell phone:
E-mail:
How long have you been at this address?
Please select ...
Less than 3 months
3 - 6 months
6 months - 1 year
1 - 2 years
2 - 5 years
5 - 10 years
Over 10 years
Do you own or rent your home?
Own
Rent
Landlord's name:
Landlord's phone:
Pets allowed?
Yes
No
How heavy is traffic on this street?
Light
Medium
Heavy
Do your windows have screens?
Yes
No
Environment
How many adults in the home?
How many children?
Ages of children?
Does anyone in the home have allergies to cats?
Yes
No
What pets do you currently have? Please include their ages and how long you have had them.
How many hours a day will Tiny Dancer be alone?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Where will Tiny Dancer be when alone?
Where will Tiny Dancer be when you are at home during the day?
Where will Tiny Dancer be when you are home at night?
Pet Care
Who provides veterinary care for your pets?
Phone:
Who will be primary caretaker for Tiny Dancer?
How often does the primary caretaker travel?
Who will take care of Tiny Dancer in an emergency or during vacations?
Experience
What pets have you had previously? Please include their ages and how long you had them.
What happened to them?
Have you ever lost a pet?
Yes
No
Have you ever had a pet hit by a car?
Yes
No
Have you ever had a declawed cat?
Yes
No
Have you ever surrendered a pet to a shelter?
Yes
No
Please explain why you surrendered the pet.
Have you ever nursed a sick animal?
Yes
No
Please describe the illness and the care provided.
Comments
Is there anything else you want to tell us?
Signature
I certify that the above information is true and understand that misrepresentations may result in the cancellation of the adoption.
Submit Application
CONTACT US:
info@peninsulacatworks.org
P.O. Box 70101, Sunnyvale, CA 94086-0101
(408) 831-2280