Humane Society Office: 410-749-7603

Wicomico County Animal Control: 410-749-1070

Salisbury City Animal Control: 410-548-3165

Cat Adoption Application

    Please Answer ALL Questions. There may be some that do not apply to you. For example, If you own your house you do not need to provide landlords name and phone number. IF ANY QUESTION DOES NOT APPLY TO YOU PLEASE ANSWER WITH "N/A"! IF ANY QUESTION IS LEFT BLANK THE APPLICATION WILL NOT SUBMIT!

    Cat name and shelter ID#:

    Your name:

    Current date and time:

    Home address (Street Name and Street Number):

    Home address (City, State, and Zip Code):

    Home phone:

    Cell phone:


    Your employer:

    Name and age of all household residents:

    Who will be primarily responsible for the cat?:

    Do you live in A:

    Do you rent, own, or live with parents:

    If you are renting, WHat is your Landlord's Name And Phone:(If You Own Put N/A)

    Are you willing to work through behavioral problems with your new cat?:

    Will you give the cat 6 weeks to adjust to their new home?:

    Will you take the cat to the vet within 7 days of adoption?:

    Do you understand that your adopted animal may require vet care as a result of shelter related illness?:

    Have you ever had to give an animal away?:

    What were the circumstances?(If you never have put N/A)

    Will you be declawing your cat:

    I prefer a cat who will...(select all that apply)

    Live IndoorsLive OutdoorsCome and Go Independently

    I will not tolerate the following(Check all that apply)

    Not using a litterboxScratching furnitureWanting to go outsideplay bitingN/AOther(explain in additional comments)

    List current pets and any pets you have had in the past 5 years:

    Current/past 5 years pet breed, type, gender, age, spayed/neutered?:

    What is your veterinarians name and phone number?:

    What name are the vet record under?

    If current pets are not up to date on vaccines or altered, explain why(if they are put n/a)

    Provide an alternate contacts name and number

    Additional comments(explain here why you chose other)(if none put N/A)

    By signing below, I understand that the falsification or omission of any of the above information will result in automatic refusal of adoption or confiscation of adopted animal. We maintain the right to refuse any application at our discretion. We maintain the right to complete a home check. I authorize HSWC to verify the information in this application. I hereby agree to release, discharge, indemnify and hold harmless the Humane Society of Wicomico County and any of its agents from any and all liabilities that may arise out of the handling by me or my party.

    Sign And Date: