Adoption Application
Forgotten Felines of Culpeper
Name of cat you're interested in adopting
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Your name
*
First Name
Last Name
Age
*
Driver's License number
*
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years at this address
*
Phone Number
*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Facebook (put "none" if not applicable)
*
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Does anyone in your household suffer from allergies (pet or otherwise)?
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Is everyone in your household aware of and agreed upon adopting a pet?
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Who will care for your pet while you are traveling?
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For how many hours a day will your pet be left alone?
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Do you own or rent your home?
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If you rent, do you have your landlord's written permission to keep a cat in your residence? Please provide name and phone number of your landlord.
What is the activity level in your home?
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Low
Medium
High
How many adults live in your household?
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How many children? What are their ages?
*
Do you intend to keep this cat...
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Indoors
Outdoors
Indoors/Outdoors
Why do you want to adopt this cat?
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What brand of cat food will you feed this cat?
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Who will be responsible for feeding the cat?
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Who will be responsible for cleaning the litter box?
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Where will you keep the cat?
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Have you ever declawed a cat?
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For what reasons would you give up the cat?
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Moving
Allergies
Illness
Biting
Scratching
Spraying
Too active
Compatibility with other pets
Hiding
Litter box problems
Destructive behavior
Pregnancy/New baby
None of the above
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Please list the animals that have shared your home in the last 2 years.
Name
Breed
Sex
Age
Indoor/Outdoor
Declawed
Still With You
If not, why?
Pet #1
Pet #2
Pet #3
Veterinary contact for above (name/phone):
Do we have your permission to contact your vet for a reference? (Please contact your vet and let them know you give permission for a reference. Thank you!)
Yes
No
How much do you think it costs per year to own a cat?
What will you do if the cost exceeds this amount?
*
Are you willing to spend the money to provide routine and emergency vet care for your pet?
*
Do you know that the average cat lives 15 to 20 years?
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Have you ever adopted an animal? From where?
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Have you ever been cited or convicted of a crime relating to animal cruelty, or do you have a charge pending?
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Yes
No
Have you ever surrendered an animal to a shelter or rescue group? If so, why?
*
Please list 3 personal references, using only one family member or partner, who can tell us why you would be a great pet owner. Let your references know our volunteer will be calling from a New York (315) area code!
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First Name
Last Name
Relationship
Phone Number
1
2
3
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Note:
We do not guarantee the health of any animals offered for adoption. Whenever you adopt an animal, you should take it to a licensed veterinarian as soon as possible. To the best of our knowledge, your cat is healthy, but will need to be started immediately on a program of preventative veterinary care. Please be aware that the pets available for adoption are rescue animals and, as such, have often been exposed to a variety of diseases. Like human illnesses, these disorders can have an incubation period of up to several weeks, or even longer. If the cat you adopt shows signs of illness at any point, you must take it promptly to your veterinarian for treatment at your expense.
By submitting this application, I acknowledge that I have answered all questions truthfully. Failure to provide truthful answers can result in the forfeiture of your adopted pet to Forgotten Felines of Culpeper. Forgotten Felines of Culpeper does not allow or disallow adoptions based on an individual’s race, gender, color, religion, national origin, ancestry, or disability. Forgotten Felines of Culpeper reserves the right to refuse the adoption of any cat without stating a reason.
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