To use the form below, print this page, fill in the form and either walk this in to our office our mail it to us at the address provided on our contact page. If you request this form in another format, please call our office at 406-541-7387.
DATE ___________ Impound Number ____________ Cat Name _____________
PERSONAL INFORMATION:
Name:_____________________________________ Home Phone:_______________
Address:______________________________________________________________
City:__________________________________ State:_____ ZIP:____________
How long at this address?__________ If less than 2 years, please list
your previous address:______________________________________________
Married:_____ Single:____ Live with parents:______ Age:________
No. of children in the home:_________ Ages:__________________________
Name of employer:_______________________________ Phone:______________
Name of spouses employer:_______________________ Phone:______________
Does anyone in your family suffer from allergies? ____________________
Have you adopted from the Missoula Animal Control before?____
RESIDENTIAL INFORMATION:
RESIDENCE: House:____ Apartment:____ Condo:____ Mobile Home:____
Landlord's name:________________________________ Phone:______________
Besides your immediate family, are there others residing in your home?
Yes:____ No:____ If yes, who?_____________________________________
ADOPTION INFORMATION:
Have you ever owned a cat?____________________________________________
Where will your cat be kept most of the time?_________________________
In the House:____ Outside:____ Other: please specify____________
Why do you want this particular cat?__________________________________
What will you do with your cat if you move?___________________________
How much do you expect to spend on your new cat in a year?____________
What will you do if your new pet scratches, dumps trash, etc.?
______________________________________________________________________
Please check all of the following that will apply to your new cat:
Mouser:____ Companion:____ Barn Cat:____ Family Pet:____
If your cat sleeps on the bed and takes up most of the bed, do you ...
(A) Make him get off the bed?
(B) Go sleep somewhere else yourself?
Are you considering having your new cat declawed?_____________________
OTHER PET INFORMATION:
Are all adult members of your household in favor of adopting a cat?
[ ]Yes [ ]No [ ]Don't know
Do you have other pets? Type and Number:______________________________
If your other pets are cats and/or dogs, are they spayed and/or
neutered?____ If no, why not?______________________________________
Are your other pets current on their vaccinations?____________________
Veterinarians name:___________________________ Phone:________________
What will you do if your newly adopted pet does not get along with
your other pets for a while?________________________________________
Do any of your pets have an infectious disease now, or have they in
the recent past? ___________________________________________________
I certify that the information provided on this form is true and
correct. I am also financially able to care for this animal. I
understand that proper food and veterinary care will be costly and am
able to meet these requirements. I understand that in some cases, a
home check may be mandatory prior to your adoption. I understand that
any false statements constitute grounds for confiscation and surrender
of the animal to the Missoula Animal Control. I further understand and
agree that the Missoula Animal Control may demand return of the animal
for any violation of the terms of the adoption contract and agreement.
Signature:____________________________________ Date:_________________
THE MISSOULA ANIMAL CONTROL RESERVES THE RIGHT TO REFUSE ANY ADOPTION.
FOR STAFF ONLY:
Approved:____ Refused:____ Comments:________________________________
Copyright © 2012 Missoula County
