I am at least 19 years old. *

Yes

No

Location of cat

Baldwin Humane Society

Petsense - Fairhope

Petco - Daphne

Applicant's Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Employer Name

First Name

Last Name

I/we live in *

House

Apartment

Condo

Mobile Home

I/we

Own

Rent

Property Manager's Phone

(###)

###

####

Spouse's Name

First Name

Last Name

Spouse's Phone

(###)

###

####

Are all current pets spayed or neutered? *

Yes

No

Are all pets up-to-date on vaccinations? *

Yes

No

If approved for adoption, this cat will spend the day *

Inside

Outside

Inside/Outside

Is any household member allergic to cats or cat litter? *

Yes

No

I understand that Baldwin Humane Society specifically prohibits declawing of cats. I affirm that, if approved to adopt, I will not have this cat declawed. *

Yes

No

I give my consent to the Baldwin Humane Society to contact the listed references. Any information obtained by Baldwin Humane Society will remain confidential. *

Yes

No