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2. Important Notice!

   Please call the shelter at 706-769-3956 to verify owner surrender procedures and available space before setting an appointment time and filling out this form!

4. Appointment Date:*
   Appointment Date:

   Appointment Date:
5. Animal Name*
6. Animal Breed(s) *
7. Animal Age*
9. First Name*
10. Last Name*
12. Email*
13. Phone Number*
14. Secondary Number
16. Address*
18. City*
19. State*
20. Zip Code*
22. How long have you had this cat?*
24. How does the cat act towards men?*
26. How does the cat act towards women?*
28. Did the cat live with children?*

    1. Yes
    2. No
29. If so, how does the cat act towards children?
30. Ages of children:
32. How was the cat kept during the daytime?*

    1. Indoors
    2. Outdoors
    3. Both Indoors and Outdoors
34. How was the cat kept during the night?*

    1. Indoors
    2. Outdoors
    3. Both Indoors and Outdoors
36. Is the cat friendly with other cats?*

    1. Yes
    2. No
    3. Unknown
38. Is the cat friendly with dogs?*

    1. Yes
    2. No
    3. Unknown
40. Does this cat chase or harm any small creatures or pets? Ex: rodents, small fowl*
42. Is the cat litter box trained?*

    1. Yes
    2. No
    3. Partially trained
44. Does the cat play with toys?*

    1. Yes
    2. No
    3. Unknown
46. Does the cat like treats? *

    1. Yes
    2. No
    3. Unknown
48. Does the cat escape? Ex: Dashing out doors*

    1. Yes
    2. No
50. Does this cat exhibit any dominant or fearful behaviors? Ex: marking, hiding, hissing, swatting*
52. Is the cat affectionate or more independent?*
54. What brand of dry food does the cat eat?*
55. Does the cat eat wet food?*

    1. Yes
    2. No
57. Why can you no longer care for this cat? *
59. Additional Comments:
61. Veterinarian:*
63. By signing below, I certify that I realize by surrendering my pet to Oconee County Animal Services it becomes the property of the county.
65. By signing below, I certify that this animal has not bitten or scratched any person within the last 10 days.
67. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
69. First Name*
70. Last Name*
72. Electronic Signature*
Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit Submit and Print

* indicates a required field