Adoption Application

Vet Information
Vet Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Vet Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
In case of Emergency

who is the main person that will care for your pet
Name

First NameLast Name
Relationship to you
Phone Number

Area CodePhone Number
Please list others that would also care for your pet.
References

Please supply 2 references and a next of kin.
Reference #1 Name*

First NameLast Name
How do you know this person?
example: relative, coworker, neighbor, friend
Phone Number*

Area CodePhone Number
Reference #2 Name*

First NameLast Name
How do you know this person?
example: relative, coworker, neighbor, friend
Phone Number*

Area CodePhone Number
Please sign and date the following statement:

By submitting this application, I certify that all of the above information is true, and I authorize a screener to contact my vet, employer, emergency person and references.
If you agree to the following please sign below and submit.
1. That this will be an indoor only cat.
2. That the cat will never be declawed.
3. That I will not hold the current foster liable for any defects or illnesses in the animal.
4. That I will allow a home visit in order to verify application information.
5. That I will allow a home visit after adoption if there is concern for the animal's well-being.
6. I attest that if for any reason I do not want or cannot keep the cat anymore, I will either:
  1. Return the cat directly to the foster parent from whom I am adopting, with no questions asked -OR-
  2. Allow the foster parent from whom I'm adopting to screen another suggested potential adopter.
Date*

MonthDayYear
Date
Signature*

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Poe's Rescue

Employment

Vet Information

In case of Emergency

References

Please sign and date the following statement: