<table style=”width:100%;”>
<tr>
<th colspan=”2″><h2 style=” text-align: left;”>I would <span style=”color:#cd4645;”>&hearts;</span> a:</h2></th>
</tr>
<tr>
<td colspan=”2″ style=” text-align: left;”>[checkbox* options “Short Only” “Fold Only” “Both Short & Fold” “Just a Sweet Kitty” “Male” “Female”]</td>
</tr>
</table>
<table style=”background-color: #dfdee1; width: 100%; border: solid 10px #dfdee1; border-spacing: 15px;”>
<tr>
<td colspan=”3″>[text* FullName placeholder “Full Name:”]</td>
</tr>
<tr>
<td colspan=”3″>[text* Address placeholder “Address:”]</td>
</tr>
<tr>
<td colspan=”2″>[text* CityState placeholder “City, State:”]</td>
<td colspan=”1″>[text* Zip placeholder “Zip:”]</td>
</tr>
<tr>
<td colspan=”1″>[tel phone placeholder “Phone:”]</td>
<td colspan=”2″>[email* email placeholder “Email:”]</td>
</tr>
</table>
<table style=”width: 100%;”>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Are you:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* employment “Employed” “Retired” “Disabled” “Student”]</td>
</tr>
<tr>
<td style=”text-align: left; font-size: 18px;”><strong>If you are employed, what is your occupation?</strong></td>
</tr>
<tr>
<td colspan=”3″>[text Occupation placeholder “Occupation:”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Are you between the ages of:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* whatage “18-25” “25-40” “40-55” “55-65” “Over 66″]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Are you:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* maritalstatus “Married” “Single” “Divorced” “Widowed”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Any children?</th>
</tr>
<tr>
<td style=” text-align: left;”>[checkbox* children “Yes” “No”]</td>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[text childrenages placeholder “Ages:”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Where do you live?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* residence “Apartment” “Condo” “Farm” “Mobile Home” “Townhouse” “House”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Do you own or rent your residence?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* ownOrRent “Own” “Rent”]</td>
</tr>
<tr>
<td colspan=”2″ style=” text-align: left;”>[text landlord placeholder “Landlord name & phone:”]</td>
</tr>
</table>
<br/>
<table style=”background-color: #dfdee1; width: 100%;”>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>Who will be responsible for the kitty’s care such as food, litter box, grooming, vet appointments?</strong></td>
</tr>
<tr>
<td colspan=”3″>[text* whoWillBeResponsibleForCare placeholder “Name of those responsible:”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Will anyone be home during the day?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* homeDuringDay “Yes” “No”]</td>
</tr>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>How many hours will kitty be left unattended?</strong></td>
</tr>
<tr>
<td colspan=”3″>[text* hoursLeftUnattended placeholder “Hours:”]</td>
</tr>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>When no one is home, where will the kitty be kept?</strong></td>
</tr>
<tr>
<td colspan=”3″>[text* whereWillKittyBeKept placeholder “Where kitty will be kept:”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Have you ever owned a kitty before?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* ownedKittyBefore “Yes” “No”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Do you travel?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* travel “Yes” “No”]</td>
</tr>
</table>
<br/>
<table style=”width: 100%;”>
<tr>
<th colspan=”4″ style=”font-size: 18px; text-align: left;”>List the type and number of pets that are currently living in your household. If none, put NA. If you need more space,  list additional pets in the comment box at the bottom:</th>
</tr>
<tr style=”background-color: #dfdee1;”>
<th style=”font-size: 18px; color: #ffffff; background-color: #605b71; vertical-align: middle;”>Names:</th>
<td>[text name1 placeholder “Name 1”]</td>
<td>[text name2 placeholder  “Name 2”]</td>
<td>[text name3 placeholder  “Name 3″]</td>
</tr>
<tr style=”background-color: #dfdee1;”>
<th style=”font-size: 18px; color: #ffffff; background-color: #605b71; vertical-align: middle;”>Breeds:</th>
<td>[text breed1 placeholder  “Breed 1”]</td>
<td>[text breed2 placeholder  “Breed 2”]</td>
<td>[text breed3 placeholder  “Breed 3″]</td>
</tr>
<tr style=”background-color: #dfdee1;”>
<th style=”font-size: 18px; color: #ffffff; background-color: #605b71; vertical-align: middle;”>Age:</th>
<td>[text age1 placeholder  “Age 1”]</td>
<td>[text age2 placeholder  “Age 2”]</td>
<td>[text age3 placeholder  “Age 3″]</td>
</tr>
<tr style=”background-color: #dfdee1;”>
<th style=”font-size: 18px; color: #ffffff; background-color: #605b71; vertical-align: middle;”>Altered:</th>
<td>[text altered1 placeholder  “Y/N”]</td>
<td>[text altered2 placeholder  “Y/N”]</td>
<td>[text altered3 placeholder  “Y/N”]</td>
</tr>
<tr style=”background-color: #dfdee1;”>
<th style=”font-size: 18px; color: #ffffff; background-color: #605b71; vertical-align: middle;”>In / Out Door</th>
<td>[text in-out1 placeholder  “In / Out”]</td>
<td>[text in-out2 placeholder  “In / Out”]</td>
<td>[text in-out3 placeholder  “In / Out”]</td>
</tr>
<tr style=”background-color: #dfdee1;”>
<th style=”font-size: 18px; color: #ffffff; background-color: #605b71; vertical-align: middle;”>Gender</th>
<td>[text m-f1 placeholder  “M / F”]</td>
<td>[text m-f2 placeholder  “M / F”]</td>
<td>[text m-f3 placeholder  “M / F”]</td>
</tr>
</table>
<br/>
<table style=”width: 100%;”>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Are these animals current on their vaccinations?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* vaccinations “Yes” “No” “N/A”]</td>
</tr>
<tr>
<td colspan=”2″>[text veterinarian placeholder “Name of Vet”]</td>
<td colspan=”1″>[tel veterinarianPhone placeholder “Phone”]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Are you financially able and willing to provide annual checkups, vaccinations, spay or neuter, and ANY medical care necessary?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* financiallyAble “Yes” “No” ]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Do you agree that you will never declaw your kitten?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* declawAgreement “Yes” “No” ]</td>
</tr>
<tr>
<th colspan=”3″ style=”font-size: 18px; text-align: left;”>Do you want this kitten for:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* kittyPurpose “Pet Only” “Breeding Rights” ]</td>
</tr>
</table>
<br/>
<table style=”background-color: #dfdee1; width: 100%; border: solid 10px #dfdee1; border-spacing: 15px;”>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>Do you have a Facebook account?</strong></td>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* facebook “Yes” “No” ]</td>
</tr>
<tr>
<td colspan=”3″>[text facebookURL placeholder “Name / Link of your account:”]</td>
</tr>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>Will you accept a friend request sent by April Larimore of Perthshire Kilts Cattery immediately upon receipt of your application?</strong></td>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* acceptFBRequest “Yes” “No” “N/A”]</td>
</tr>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>Do you agree to send updates on Kitten with pictures and videos through Facebook messenger, text, or email to Perthshire Kilts Cattery until the kitten is 1 year old? </strong></td>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* kittenUpdates “Yes” “No”]</td>
</tr>
<tr>
<td colspan=”3″ style=”text-align: left; font-size: 18px;”><strong>Do you agree to give <em>facebook.com/scottishkiltkittens</em> permission to post any photos and videos sent by you? </strong></td>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* facebookPostAgreenemt “Yes” “No” “N/A”]</td>
</tr>
</table>
<br/>
<table style=”width:100%”>
<tr>
<th colspan=”3″ style=”text-align:left; font-size:18px;”>Please tell me why you / your family would make THE BEST Mommy or Daddy for this kitten:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[textarea* whyChooseYou]</td>
</tr>
</table>
<br/>
<table style=”background-color: #dfdee1; width: 100%; border: solid 10px #dfdee1; border-spacing: 15px;”>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>Are you willing to sign a legally binding pet contract?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* willingToSignPetContract “Yes” “No”]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>Are you in contact with another breeder, have made a deposit, or on a waiting list?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* inContactwithAnotherBreeder “Yes” “No”]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>If yes, what is the breeder’s name?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[text breedersName placeholder “Breeders Name:”]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>Do you agree to provide a copy of your current Driver’s License?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox* DriverLicense “Yes” “No” “N/A”]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>Please upload an Image of your drivers license. <em>*All of your personal information will be used for the sole purpose of selecting the best fit for a kitten. We will never share any information to anyone, for any reason.</em></th>
</tr>
<tr>
<td style=”text-align: left;”>[file file-373 limit:1mb filetypes:gif|png|jpg|jpeg|pdf|doc|docx]</td>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox sendIDlater “Send Later”]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>How did you find us?</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox findUs “Google” “Ebay” “Facebook” “Hoobly” “Referral” “Other”]</td>
</tr>
<tr>
<td colspan=”1″>[text referralName placeholder “Referred By:”]</td>
<td colspan=”2″>[text other placeholder “Other:”]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align: left; font-size: 18px;”>Do you need:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[checkbox delivery “Delivery” “Pick up at Cattery” “Meet Part Way” “Undecided”]</td>
</tr>
</table>
<br/>
<table style=”width:100%”>
<tr>
<th colspan=”3″ style=”text-align:left; font-size:18px;”>Any additional information including any other pets can be listed here:</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[textarea additionalInformation]</td>
</tr>
<tr>
<th colspan=”3″ style=”text-align:left; font-size:18px;”>[checkbox* Acknowledgment “I acknowledge that all information on this form is true and correct.”]</th>
</tr>
<tr>
<td colspan=”3″ style=” text-align: left;”>[submit “Send”]</td>
</tr>
</table>

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