Adoption Application

Name *

First

Last

Address *

City *

State *

Zip *

Primary Phone *

Cell Phone

Email *

Email

Confirm Email

1) Name of cat(s) you are applying for: *

2) Description of the cat you are apply (or looking) for: *

3) Do you want this cat for: *

Companion (yourself)
Gift
Other

4) How many days a week will the cat be left alone? (ex: work, go out, etc.)? *

For how many hours? *

5) Where will the cat be kept during the day? (check all that apply) *

Please specify if "other" *

Enter "NA" if this question does not apply to your situation.

At night? (check all that apply) *

Please specify if "other" *

Enter "NA" if this question does not apply to your situation.

6) Do you prefer a declawed cat? *

Yes
No

7) Where do you live? *

House
Apartment
Townhouse
Other

Please specify if "other" *

Enter "NA" if this question does not apply to your situation.

Do you: *

Own
Rent
Live with parents

Landlord's Name: *

Enter "NA" if this question does not apply to your situation.

Phone: *

Enter "NA" if this question does not apply to your situation.

8) Does your landlord allow cats? *

Yes
No
Don't know
Not applicable

Deposit required? *

Enter "NA" if this question does not apply to your situation.

Monthly rental increase? *

Enter "NA" if this question does not apply to your situation.

9) How many adults in your household? *

Ages: *

Enter "NA" if this question does not apply to your situation.

How many children? *

Ages: *

Enter "NA" if this question does not apply to your situation.

10) Is anyone in your home allergic to cats? *

Yes
No

11) If you move in the future, what will you do with your cat(s)? *

12) If something should happen to you, who would care for your pet(s)? *

13) How much do you anticipate spending yearly to feed, vaccinate, license, and provide medical care? *

14) Would you be willing to let us visit your home before the adoption is complete? *

Yes
No

15) Have you ever given a pet up? *

Yes
No

Why? *

16) What types of pet(s) do you own or have you owned in the last 10 years? Please include names and ages. *

What is (was) the name of your veterinarian for the above animals? *

PLEASE CONTACT YOUR VET AND GIVE PERMISSION FOR THEM TO SPEAK WITH RESCUE KITTY™
Enter "NA" if this question does not apply to your situation.

Phone: *

Enter "NA" if this question does not apply to your situation.

17) Please provide 2 personal references: *

First & Last Name

Phone *

Phone Number

Reference #2 Name *

First & Last Name

Reference #2 Phone *

Phone Number

18) Do you realize that a cat may live up to 15 years or more? *

Yes
No

19) It may take your new cat two or more weeks to adjust to its new home, especially if other pets are involved. Are you prepared to allow this much time? *

Yes
No

20) When would you be ready to bring your new cat home if approved? *

ELECTRONIC SIGNATURE: By signing below, I certify that the information I have given is true and that I recognize that any misrepresentation of the facts may result in my losing privilege of adopting a cat from Rescue Kitty™ I authorize investigation of all statements on this application. *

Please type your First and Last Name

E-signature agreement *

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

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