Adoption Application

NEPA CAT RESCUE Inc.

Name of Cat/Kitten interested in:
Please list your Facebook profile name if that is how you found us so we can get back to you via FB Messanger
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at this address?:*
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Up until what time of night can we contact you via phone?*
E-mail*
Are you able to afford a donation of up to and no great than $100?*

YesNo
How were you referred to NEPA Cat Rescue?*
Are you planning on moving within the next 6 months?*

YesNo
If yes, what are your plans for your pets if you move?
Do you own your own home?*

YesNo
If no, name and phone # of landlord:
Type of Dwelling:*
Please list any type of pet you currently own, especially the breed of dog if applicable :*
What is your reason for wanting to adopt a cat?*

HousepetMouse PatrolCompanionCompanion for petGiftOther
If other, please explain:
How many total hours will your new pet be left alone during the day?*
If adopting a kitten, where would the kitten be kept when alone?
Are you planning on declawing your new cat or kitten?*

YesNoMaybe
Are your current cats declawed?*

YesNoN/A
Are any members of your household allergic to animals?*

YesNo
If yes, please describe:
Who will have chief responsibility for the care of your new pet?*
Over the past 5 years, how many pets have you owned? (Include current pets)*
List each individually including breed, age, still living with you? (if not, why?)
Have you and your spouse (if applicable) ever owned a cat together?*

YesNoN/A
If yes, when?
Have you ever lost or given away a pet?*

YesNo
If you currently own a dog or cat, how does he/she react to new cats?
Are your present pets up-to-date on their annual vaccines?*

YesNoN/A
If no, please explain:
Are your present pets spayed or neutered?*

YesNoN/A
If no, please explain.
Were your previous pets spayed or neutered?*

YesNoN/A
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?*
What plans do you have for your new pet when you are on vacation?*
Which cat(s) on our website are you interested in?*
Age of cat you would consider adopting: (check all that apply)*

KittenYoungAdultSpecial NeedsSenior
Can/Will you provide your cat with monthly flea/tick prevention?*

YesNo
Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER: PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE PERMISSION TO RELEASE INFORMATION AS MANY WILL NOT GIVE US A REFERENCE W/OUT YOUR CALL, AND WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION.*
If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?*

Contact a ProfessionalUse a bookPersonal KnowledgeOther
If other, please explain:
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?*

Move box to new locationTry a different litterClean box more oftenHave cat examined by vetUse a cat doorReturn CatNoneOther
If other, please explain:
Is your entire immediate family in agreement with the decision to bring a new pet into your home?*

YesNo
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)?*

YesNo
Are you willing to allow Nepa Cat Rescue to make future visits to your home?*

YesNo
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?*

YesNo
If yes, please describe:
Have you ever adopted or tried to adopt a pet before? If yes, fill out info below.*

YesNo
Rescue Information

Name of RescueContact Name
Rescue's Phone Number

Area CodePhone Number
Why are you choosing to adopt vs. buying from a pet store or breeder?*
Where will your cat spend most of his/her time?*
If you selected outdoor, would your cat be supervised?

YesNo
Please provide 3 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved. PLEASE BE AWARE: If your references are not easily reachable or do not reply in a timely manner, it will delay your application. If multiple references do not reply, your application will be filed on HOLD. Please choose your references carefully and be sure to list the correct contact numbers.
Reference #1*
First and Last Name & Relationship to Self
Reference # 1 Phone Number*

Area CodePhone Number
Reference #2*
First and Last Name & Relationship to Self
Reference #2 Phone Number*

Area CodePhone Number
Reference #3*
First and Last Name & Relationship to Self
Reference # 3 Phone Number*

Area CodePhone Number
If there is anything else you think we should know, please note it here.
Once we have received your application, you will receive an email confirmation within 24 hours.
Thank you so much for wanting to rescue a cat!!
Should be Empty:

NEPA CAT RESCUE Inc.

Once we have received your application, you will receive an email confirmation within 24 hours.

Thank you so much for wanting to rescue a cat!!