Kindred Kitties Ltd.

&nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p;

K= indred Kitties Ltd.

&= nbsp; 614 59^th Street

Kenosha<= span style=3D'font-family:Verdana'>, WI 53140=

262/605-0533

www.kindredkitties.org

We Find Homes For Homeless Ki= tties

You must be at = least 21 years of age, and all members of your household must consent to the adoption.

How did you= hear about us? (Circle One) Newspaper Internet Walk-In= Referral Other ___________

Name: &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; Phone #: &n= bsp; = ; &n= bsp;

Address: &n= bsp; = ; &n= bsp; = ; ___________ ______ # of Years? &= nbsp; ___________

City, State, Zip: &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp;

Own Rent = Other = If you own, circle one: House Condo Mobile Home Other

Landlord’s name & = phone number: &= nbsp; &nbs= p; &= nbsp; &nbs= p; How many cats permitted? ____=

If you planning to move with= in the next 6 months, what will you do with your cat? = = =

Number of Adults in Househol= d? Number of Chil= dren in Household? Ages of Children: &= nbsp;

Employer: &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; Number of Years? &= nbsp; &nbs= p;

Occupation: &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp;

Animals You Currently Own

Type:             =             &nb= sp;            =             &nb= sp;            =           Spayed/Neutered?         &= nbsp;   ** Age:            <= /u>

Type:             =             &nb= sp;            =             &nb= sp;            =           Spayed/Neutered?         &= nbsp;   ** Age:            <= /u>

Are animals current on all s= hots?         &= nbsp;           &nbs= p;   If not, why?         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;          =

** If your animal is not Spayed/Neutered, why not?   &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;
Veterinarian
Veterinaria= n’s Name:      &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;     Visit regularly?         &= nbsp;

Animals You Have Owned in the Past <= /span>

Type:             =             &nb= sp;            =             &nb= sp;            =           Spayed/Neutered?         &= nbsp;     Age:             =

Years Owned:         &= nbsp;           &nbs= p;      What happened to this animal?=         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;        <= /p>
Type:             =             &nb= sp;            =             &nb= sp;            =           Spayed/Neutered?         &= nbsp;     Age:             =

Years Owned:         &= nbsp;           &nbs= p;      What happened to this animal?=         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;                     =

Informational Questions
Please answer the below ques= tions in full – leaving a question blank or putting ‘N/A’ is not considered an answer. If you have questions, please cons= ult a Kindred Kitties Volunteer.

Have you ever released an an= imal to a shelter or outside?   &nb= sp;           If yes, why?         &= nbsp;           &nbs= p;

           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

What would happen to your ca= t if you:

       Moved?       &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =

       Got Divorced?      = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;

       Started a relationship with a cat hater? &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;

       Developed allergies?      = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;

       Went on vacation?     &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;

Are you prepared to care for= your cat for its life span of a possible 20 years?             =             &nb= sp;            =

If you have children in your= home or are planning on having children, what are you prepared to do to introduce the child to the kitten/cat?   = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;            = ;                   &= nbsp;           &nbs= p;         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

Are you aware of the outside dangers to your cat? Yes <= span style=3D'mso-tab-count:1'>     No     _

If yes, what are some of the dangers?      &= nbsp;           &nbs= p;            &= nbsp;       _

           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

In the event of your untimely death, what would happen to your cat? &n= bsp;            = ;            &n= bsp;            = ;

           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

Cats have an adjustment peri= od from 5 minutes to 5 months. H= ow would you and your family cope with a longer adjustment period?         &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

If this cat has a behavior problem, how would you and your family handle this situation?        <= o:p>

           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

Please list the reasons why = you want to adopt a cat:    &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;

            = ;              =          =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =

If= you are planning on or think you may be adopting a second cat from us you may d= o so in the next six months for the price of $50. After that time the price will ret= urn to $80. ___________(Initial)

I<= /span> agree that the above information is true and accurate to the best of my knowledge.

_______________________________________________= _        &= nbsp;           &nbs= p; ____________________ Signature            = ;            &n= bsp;            = ;            &n= bsp;            = ;            &n= bsp;        Date

   Kindred Kitties will review = and reserves the right to reject any application made.