Address: ______________________________________________

City: ______________ State: ___________ Zip Code: __________

Home phone: ______________ Cell: ______________

E-mail address: _______________________________

1) I would consider my household to be like: A Library _________ Middle of the road ________

A carnival  _______

2) I am comfortable with a cat that likes to play “chase my ankles” and similar games

Yes _____ No _______ Somewhat ________

3) I want my cat to interact with guests that come to my house

Little of the time ______ Some of the time _________ All of the time __________

4) How do you feel about a boisterous cat that gets into everything?

Love them but rather not live with them _____ Depends o situation______ Fine by me ______

5) My cat needs to be able to adjust to new situations quickly: Not important_________

Somewhat _________ Yes _________

6) I want my cat to love being with children in my home: It’s not important __________

Some of the time ___________ Most of the time __________

7) My cat needs to be able to be alone: More than 9 hours a day _______ 4 to 8 hours per day __________ Less than 4 hours per day __________

8) I want my cat to enjoy being held: Little of the time: Little of the time __________

Some of the time _________ Most of the time ________

9) I need my cat to get along with (check all that apply): Dogs ______ Cats _____ Birds ______

10) My cat will be: Inside: ________ Inside/Outside __________ Outside ________

11)  I have lived with cats before: Yes ______ No ______ Currently _________

12) I prefer my cat to be talkative: Yes _______ No ______ It’s not important __________

13) I want my cat to play with toys: Little of the time ______ Sometimes ______ Often ________

14) I want my cat to be active: Not very active_____ Somewhat ______ Yes, very _______