Name

Address

Primary Phone

Secondary Phone

Email

Date of Birth

Employer

Job Title:

Does your job include frequent travel? Yes No

If yes, how will you arrange to take care of the cat(s)?

In what type of home do you live? Apartment Condo Trailer House

Do you own or rent? Own Rent

If you rent does your lease allow cats? Yes No

If you rent, what is the name and phone number of your landlord/property management company?

Please list all of the people living in your household including their name, age and relationship to you:

How would you describe your household? Quiet Average Hectic

If you share your dwelling, are all members of the household in agreement concerning the fostering of a senior cat? Yes No

Are you or anyone in your household allergic to animals? Yes No

If yes, how do you intend to deal with this?

Will this Senior Cat have free range of your home? Yes No

If no, please explain:

Please list ALL pets currently living in your home including name, breed, age, if they are spayed/neutered, if they are current on vaccinations, and if they have tested negative for FIV/FeLV:

Who is your current veterinarian (or previous veterinarian if you’ve owned pets within the last 5 years)? Please list their name and phone number:

Have you ever surrendered a pet to a shelter or rescue? Yes No

If yes, what were the circumstances?

Please list a non-family reference and including name, phone, relationship and years known:

How many hours a day would the Senior Cat be left alone?

Are you willing to spend the time and effort necessary to help this pet adjust to your home and lifestyle? Yes No

Do you have a doggie door installed in your home? Yes No

Would you agree to a home visit? Yes No

Under what circumstances would you not keep this cat?

What would you do if the cat urinated or defecated outside of the litter box?

Please list any comments or questions for us:

How did you hear about Laps and Naps?

Which cat or cats are you interested in fostering? (If you don’t have a cat in mind leave blank)

*I have read and agree to the Terms and Conditions