Cat Adoption Form

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Image FieldCountry Kitten Rescue Adoption Application
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Full Name* This field is required.
First Name
Last Name
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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How long at this address?:* This field is required.
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Home Phone Number
Area Code
Phone Number
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Cell Phone Number
Area Code
Phone Number
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Name and Address of Employer:
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Work Phone Number
Area Code
Phone Number
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E-mail* This field is required.
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Up until what time of night can we contact you via phone?* This field is required.
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Are you able to afford the adoption fee?* This field is required.
Yes
No
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How were you referred to Country Kitten Rescue?* This field is required.
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Are you planning on moving within the next 6 months?* This field is required.
Yes
No
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If yes, what are your plans for your pets if you move?
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Are you 18 years of age or older?* This field is required.
Yes
No
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Birth Date* This field is required.
Month
Day
Year
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Do you own your own home?* This field is required.
Yes
No
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If no, name and phone # of landlord:
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Type of Dwelling:* This field is required.
Please Select
Please Select
House
Apartment
Condo
Mobile Home
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Name and age of ALL occupants in household (including yourself):* This field is required.You MUST include name AND age of ALL occupants!
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If no children, do you plan on having children or will children be visiting the household frequently?* This field is required.
Yes
No
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What is your reason for wanting to adopt a cat?* This field is required.
Housepet
Mouse Patrol
Companion
Companion for pet
Gift
Other
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If other, please explain:
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How many total hours will your new pet be left alone during the day?* This field is required.
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If adopting a kitten, where would the kitten be kept when alone?
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Are you planning on declawing your new cat or kitten?* This field is required.
Yes
No
Maybe
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Are your current cats declawed?* This field is required.
Yes
No
N/A
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Are any members of your household allergic to animals?* This field is required.
Yes
No
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If yes, please describe:
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Who will have chief responsibility for the care of your new pet?* This field is required.
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Over the past 5 years, how many pets have you owned? (Include current pets)* This field is required.
Please Select
Please Select
0
1
2
3
4
5
6+
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List each individually including breed, age, still living with you? (if not, why?)Please be very specific.
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Have you and your spouse (if applicable) ever owned a cat together?* This field is required.
Yes
No
N/A
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If yes, when?
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Have you ever lost or given away a pet?* This field is required.
Yes
No
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If you currently own a dog or cat, how does he/she react to new cats?
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Are your present pets up-to-date on their annual vaccines?* This field is required.
Yes
No
N/A
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If no, please explain:
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Are your present pets spayed or neutered?* This field is required.
Yes
No
N/A
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If no, please explain.
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Were your previous pets spayed or neutered?* This field is required.
Yes
No
N/A
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If no, please explain.
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How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?* This field is required.
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What plans do you have for your new pet when you are on vacation?* This field is required.
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Which cat(s) on our website are you interested in?* This field is required.
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Age of cat you would consider adopting: (check all that apply)* This field is required.Check all that apply
Kitten
Young
Adult
Special Needs
Senior
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Can/Will you provide your cat with monthly flea/tick prevention?* This field is required.
Yes
No
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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.* This field is required.You MUST call your vet to give permission to release your records. We CANNOT process your application if this is not done. This is extremely important.
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If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?* This field is required.
Contact a Professional
Use a book
Personal Knowledge
Other
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If other, please explain:
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What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?* This field is required.
Move box to new location
Try a different litter
Clean box more often
Have cat examined by vet
Use a cat door
Return Cat
None
Other
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If other, please explain:
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Is your entire immediate family in agreement with the decision to bring a new pet into your home?* This field is required.
Yes
No
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If anyone is NOT, please explain:
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Are you prepared to commit to a pet for 15 - 20 years (average life span)?* This field is required.
Yes
No
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Are you willing to allow CKR to make future visits to your home?* This field is required.
Yes
No
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Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?* This field is required.
Yes
No
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If yes, please describe:
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Why are you choosing to adopt vs. buying from a pet store or breeder?* This field is required.
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Where will your cat spend most of his/her time?* This field is required.
Please Select
Please Select
Indoors Only
Outdoors Only
Indoors and Outdoors
Barn Cat
Basement/Garage
Confined
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If you selected outdoor, would your cat be supervised?
Yes
No
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Where will your cat eat?* This field is required.
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Where will your cat sleep?* This field is required.
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Reference #1* This field is required.
First and Last Name & Relationship to Self
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Reference # 1 Phone Number* This field is required.
Area Code
Phone Number
66
Reference #2* This field is required.
First and Last Name & Relationship to Self
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Reference #2 Phone Number* This field is required.
Area Code
Phone Number
68
Reference #3* This field is required.
First and Last Name & Relationship to Self
69
Reference # 3 Phone Number* This field is required.
Area Code
Phone Number
70
If there is anything else you think we should know, please note it here.
Should be Empty: