We request the following information and a consultation with an adoption counselor to help you find a cat with the qualities you’d like and who matches your lifestyle.

To be considered as an adopter, you must:

Be 21 years of age
Have the knowledge and consent of all adults living in your household
Have a valid ID with current address
Have the knowledge and consent of your landlord if applicable
Understand that The Worcester Country Humane Society must approve your application

Thank you for your submission.

My Preferences

About Me and My Home

What type of home do you live in?

Apartment

Condo

Duplex

House

Mobile

Other

Please select what type of home you live in.

Do you rent or own your home?

Own

Rent

Please select rent or own your home.

Number of adults in your household:

Please add the number of adults in your household:.

Number of children (under age 18) in your home

Please add the number of children (under age 18) in your home.

Ages

Are there any persons who regularly visit the home (grandchildren, family members, etc)? Explain and list visitor(s) ages below.

Please add visitors.

My Habits

Contact Info

First Name

Please add your First Name.

Middle Name

Last Name

Please add your Last Name.

Date of Birth

Please add your Date of Birth.

Home Phone

Please add your Home Phone.

Cell Phone

Please add your Email.

Address

Please add your Address.

City

Please add your City.

State

Please add your State.

Zip Code

Please add your Zip Code.

Do you own or rent?

Own

Rent

Please select if you own or rent?

How long have you lived at the address?

Please add how long have you lived at the address?

List previous address.

Are You:

Attending school

Homemaker

Retired

Working

Other

Please select your status.

Other

What pets have you owned in the past?

Please list 2 personal references (not related to you)*

Reference Name 1

Please add your Reference Name 1.

Reference Phone 1

Please add your Reference Phone 1.

Reference Name 2

Please add your Reference Name 2.

Reference Phone 2

Please add your Reference Phone 2.

By submitting this form, I certify that the information I have given is true and that I recognize that any misrepresentation of the facts may result in my losing privilege of adopting a pet. I authorize investigation of all statements on this application.

I agree.

Please select your Agreed to terms.

How did you hear?

Facebook

Fundraiser

Website

Other

Feline (Cat) Adoption Application

My Preferences

About Me and My Home

My Habits

Contact Info

What pets have you owned in the past?

Please list 2 personal references (not related to you)*

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