Baby Jack's Rescue, Inc. Adoption Form
Name as it appears on your Driver's License
*
First Name
Last Name
Name of Pet you wish to Adopt
Please provide your Facebook name and/or Instagram name
*
Address
*
Street Address, including apartment # if you have one.
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please provide your birthdate
*
Please provide ALL parties in the household and birthdate.
*
Do you own or rent your home?
*
If you rent, please provide you landlord's name & phone
Please list current pets, newest of vaccines date and Felv/Fiv testing date.
Are your other animals good with cats?
Will your cat be indoor or outdoor?
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Will you be declawing?
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Please provide your veterinarian's name and phone number. Please include any past veterinarian or shot clinic you have used. Please call the veterinary office to allow a vet check to be completed as records can not be released with permission.
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If you have a medical emergency and your cat requires surgery, please explain to us how you will be taking care of that situation. Remember your animals, are a lifetime commitment.
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Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?
If you go on vacation or leave town, who would care or your pet?
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Have you ever been convicted of an animal related crime, such as cruelty of animals, animal theft, or animal abandonment?
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If you answered "YES" please provide a detailed description.
Signature of Potential Pet Parent
By providing your initials, you are agreeing to have your adopted pet neutered by 5 month/4 pounds , & spayed 6 months/5.5 pounds. Your initials will also, serve right to BJR to regain the animal you adopted if proof of spay/neuter is not provided to the rescue.
Submit
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