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Barn Cat Placement Application
Please fill out the full application and return to HSMC. Incomplete applications will not be processed. An HSMC representative will contact you upon cat availability.
Name
Address
City
Zip
Home Phone
Cell Phone
Work Phone
Date of Borth
Email
Living Accomodations
House
Mobile Home
Apartment
Rent
Own
Other
If Other
Landlord / Apt Mgr
Live Here Full Time
Yes
No
Cat Housing
Describe the structure in which the cat will be housed
Property Size
Why do you want a barn cat?
Barn cats must be securely confined for 1 week. Are you prepared to allow this much time?
Yes
No
Who will be responsible for the barn cats' care?
Who will care for your barn cats if you are away?
Do you agree to trap and take to a vet a barn cat that becomes ill or injured?
Yes
No
Have you had barn cats before?
Yes
No
What happened to the cats that are no longer with you?
I have read the above information carefully and have filled out the application honestly. By signing below, I certify that the information I have given is true. I understand that omission of information and/or failure to answer all asked questions honestly can result in this application being declined. Also, if an omission, untruth or neglect is discovered after adoption takes place, I understand that HSMC reserves the right to annul the adoption and reclaim the animal. I give HSMC permission to fully investigate the information provided and related officials. I understand that feral and semi-feral cats can be unpredictable and as a caretaker I will take proper precaution and understand that HSMC cannot be held liable.
Signature