Feline (Cat) Adoption Application

Applicant & Household Member Information

Primary Applicant Full Name

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Date of Birth

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Phone Number

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Email Address

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Street Address

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City/State/Zip

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Additional Adult Household Members

Please list the full name (first, middle, last) and date of birth for all other individuals aged 18 or older residing in the home.

Household & Living Environment

Housing Type House Apartment Condo Mobile Home

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Ownership Own Rent Live with Parents

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If renting, landlord name and phone

If you own, whose name is the home titled in?

Do you have a fenced yard? Yes No

Please correct your Do you have a fenced yard?.

If yes, fence height and material

Does the fence completely enclose the yard? Yes No

Please correct your Does the fence completely enclose the yard?.

If you do not have a fence, how will the dog safely exercise and relieve themselves?

Number of adults in the home

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Number of Children

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Is anyone in the household allergic to pets? Yes No

Please correct your Is anyone in the household allergic to pets?.

Current & Past Pets (Last 5 Years)

Pet 1 (Name/Breed/Age)

Spayed/Neutered Yes No

Pet 2 (Name/Breed/Age)

Spayed/Neutered Yes No

Pet 3 (Name/Breed/Age)

Spayed/Neutered Yes No

Pet 4 (Name/Breed/Age)

Spayed/Neutered Yes No

Pet 5 (Name/Breed/Age)

Spayed/Neutered Yes No

Current or Past Veterinarian/Clinic Name

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Clinic Phone Number

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Name on Veterinary Records

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Please provide two personal references who do not live with you and are not related to you.

Full Name

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Relationship to Applicant

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Phone Number

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Please correct your Email.

Relationship to Applicant

Your New Pet Preferences

I am applying to adopt a Dog Cat No specific animal yet

Please correct your I am applying to adopt a.

Name of specific animal (if known)

Desired age range: Puppy/Kitten Young Adult Senior

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Desired energy level Low (Couch potato) Moderate High (Running buddy)

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Will this cat be strictly Indoors only Outdoors only Indoor / Outdoor combo

Please correct your Will this cat be strictly.

Do you have a screened porch, catio, or protected outdoor area? Yes No

Please correct your Do you have a screened porch, catio, or protected outdoor area?.

Are your home windows and doors securely screened? Yes No

Please correct your Are your home windows and doors securely screened?.

Where will the cat sleep at night?

Please correct your Where will the cat sleep at night? .

Where do you plan to place the litter box(es)?

Please correct your Where do you plan to place the litter box(es)?.

How many hours will the cat be left alone during the day?

Please correct your How many hours will the cat be left alone during the day?.

What are your views on scratching behavior? Scratching furniture is unacceptable; I prefer a cat that doesn't scratch. I will provide scratchers, posts, and redirection to protect furniture

Please correct your What are your views on scratching behavior?.

What is your stance on declawing a cat? PLEASE NOTE: DECLAWING IS ILLEGAL IN MARYLAND I plan to declaw this cat. I will not declaw this cat under any circumstances. I am undecided / need more information on alternatives.

Please correct your What is your stance on declawing a cat? PLEASE NOTE: DECLAWING IS ILLEGAL IN MARYLAND.

If the cat develops litter box issues (stops using the box), what steps will you take?

Please correct your If the cat develops litter box issues (stops using the box), what steps will you take?.

Desired personality trait: Playful & Energetic Independent Calm Lap-Cat Shy/Needs patience

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Experience level with cats First-time owner Intermediate Experienced with medical/behavioral needs

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Are you willing to adopt a cat that requires active care or behavior support? Yes No

Please correct your Are you willing to adopt a cat that requires active care or behavior support?.

Ringworm treatment / Recovering medical: Yes No

Please correct your Ringworm treatment / Recovering medical:.

Daily oral or injectable medications: Yes No

Please correct your Daily oral or injectable medications:.

Extreme shyness / Under-socialization Yes No

Please correct your Extreme shyness / Under-socialization.

What traits are most important to you in your new cat? (Check all that apply) Good with young children Good with other cats Good with dogs Tolerant of handling

Please correct your What traits are most important to you in your new cat? (Check all that apply).

Are there any plants or flowers in your home? Yes No

Please correct your Are there any plants or flowers in your home? .

Note: Certain common household plants and flowers, such as lilies, are highly toxic and fatal to cats.

Additional Information

Please use this space to share any additional information, special circumstances, or personal experiences that you believe will help us evaluate your application and find the best match for your household.

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Notice of Automatic Denial & Application Policies

Please review the following criteria and shelter policies carefully. The Worcester County Humane Society reserves the right to automatically deny any application for the reasons listed below:

Untruthful Statements: Providing false, misleading, or exaggerated information anywhere on this application.
Incomplete Application: Leaving required sections, contact numbers, or signatures blank. Significant delays occur due to questions that arise due to incomplete information.
Failed Veterinary Check: Past or present pets not up to date on legally required vaccines (e.g., Rabies), missing regular medical care, not tested nor on Heartworm Preventative (dogs).
Intact Pets: Current pets in the household that are not spayed or neutered without a verified medical exemption from a veterinarian.
Landlord Disapproval: Lack of consent from a landlord, or applying for a pet breed/size restricted by your lease or HOA policy.
History of Animal Abuse: Any past convictions, citations, or documented history of animal neglect, abuse, or abandonment.
History of Violent Offenses: Any past convictions, citations, or documented history of violent crimes, domestic abuse, or assault.
Age Requirement: Applicant is under 21 years of age.

Important Shelter Policies

Shelter Visits: Please note visits to the shelter are strongly encouraged to meet the pet you are interested in, but not required to adopt.
Trait Matching: Applications may not be processed if desired pet traits do not match any animal we have.
Application Expiration: WCHS does not keep lists; approved applications are only good for 30 days.
No Holds / Multiple Applications: We do not hold or reserve any animals, and do accept more than one application on a specific animal, until the animal has left the building and been officially adopted.

Under what circumstances would you return or surrender an adopted pet?

Please correct your Under what circumstances would you return or surrender an adopted pet?.

I have read, understand, and agree to follow all of the Worcester County Humane Society policies, rules, and automatic denial criteria listed above.

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Acknowledgement & Signature

By signing below, I certify that all information provided is true and correct. I authorize the Worcester County Humane Society to contact my landlord, personal references, and veterinarian to verify this information.

Signature

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Date

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Office Staff Reviewer

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Worcester County Humane Society | No Kill Shelter

Applicant & Household Member Information

Additional Adult Household Members

Household & Living Environment

Current & Past Pets (Last 5 Years)

Personal References

Reference 1

Reference 2

Your New Pet Preferences

Additional Information

Notice of Automatic Denial & Application Policies

Important Shelter Policies

Acknowledgement & Signature