ICR ADOPTION FORM

YOUR NAME*

Phone Number *

Email*

Cat/s interested in and why?*

ARE YOU OVER 21 YEARS OF AGE?*

ADDRESS*

HOW LONG AT THIS ADDRESS?*

OWN YOUR HOME?*

RENT? (If yes, you must have landlord approval)*

Are you employed, full time, part time or retired? *

Have you ever adopted a cat/kitten from ICR?*

Have you ever been refused adoption of a pet from any other rescue/charity?*

Who would look after them if you went away?*

Name the brand of flea/worm treatment you would use.*

HAVE YOU OWNED PETS IN THE PAST 3 YEARS?*

IF YES, WHAT HAPPENED TO THEM?*

WHAT ANIMALS DO YOU OWN NOW?*

ARE THEY SPAYED OR NEUTERED?*

IF NO, PLEASE EXPLAIN:*

What is your opinion on spaying/neutering, if you had previous pets were they spayed/neutered and did you let them have any litters?*

Are your current pets vaccinated and do you keep up with yearly boosters?*

YesNo

WHICH VETERINARY CLINIC DO/WOULD YOU USE?*

ARE THERE CHILDREN IN THE FAMILY?*

YesNo

IF YES, WHAT ARE THEIR AGES?*

List other members of the household*

HAVE YOU EVER PLACED A PET IN A RESCUE?*

YesNo

IF YES, WHAT WAS THE REASON?*

Which brand of food would/do you feed your cat and how often?*

Do you/will you use pet insurance on your own animals? If you don’t or plan to have insurance will you be able to pay out vet fees in full if your animal needs urgent veterinary treatment?*

Where will they be kept during the day/night?*

Do you plan to let them outside?*

YesNo

Would they have access to a safe outdoor space away from busy/main roads?*

How long would you leave your cat/kitten(s) alone for?*

What would you do if they missed the litter tray/ kept you awake at night or started to scratch at furniture?*

Do you plan on putting a collar on them/Id tag, if so what kind of collar?*

Are any members of the household allergic to cats?*

Do you own a cat carrier?*

YesNo

ARE YOU FINANCIALLY PREPARED TO PROVIDE THE NECESSARY CARE FOR YOUR PET: INCLUDING PROPER FOOD, VACCINATIONS, PARASITE CONTROL (FLEAS, TICKS, WORMS, ETC.) ADEQUATE SHELTER, AND VETERINARY CARE FOR YEARLY CHECK-UPS AND MEDICAL EMERGENCIES?*

BY TYPING MY FULL NAME BELOW, I CAN CONFIRM THAT ALL INFORMATION ABOVE IS TRUE. I REALIZE THAT THIS IS A LIFETIME COMMITMENT AND WILL ENDEAVOR TO GIVE THIS PET A HAPPY AND HEALTHY HOME. IF THERE ARE PROBLEMS WITH THIS PET OR I MUST GIVE HIM UP I WILL CONTACT ICR.*

Name as it appears on Facebook

ICR ADOPTION APPLICATION