Cocoa & Friends Cat Rescue Pet Adoption Application Form

COCOA & FRIENDS CAT RESCUE, INC.

Adoption Application, Contract and Waiver

All fields required

In order to best match our cats with prospective adopters, we require that each question on the application be answered. It will give us a better understanding of your lifestyle, your experience with cats, and your philosophies on pet ownership. Thank you for your cooperation!

In order to adopt a cat you must:

-Be 18 years, or older

-Have a valid driver's license or ID

-Pay the $130 adoption fee. $200 for 2 cats

-Be able to absorb the costs for veterinary care, food, supplies, etc.

Applicant's Name*

First NameLast Name

Name of Pet You Wish to Adopt

Are you adopting a pet for your home, someone else, for your workplace?*

Email Address

example@example.com

Phone Number*

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Occupation*

Employer Phone*

Work Schedule

How long have you been at your current job?*

Does your job require travel? If so, how often?*

Do you own or rent your home?*

OwnRent

How long have you lived at your current residence?*

If you rent, what is your landlord's pet policy?*

If you rent, please provide your landlord's contact information.

Do you live with anyone else? If so, whom ? Please list adults full names and their relationship to you*

Are there children in the home? (If yes, please list ages)

Does everyone in the home wish to adopt a cat?*

YesNo

Is anyone allergic?*

YesNoOther

Do you have smoke detectors?*

YesNo

Are your windows completely screened?*

YesNo

Do you have any of the following?*

Have you had pets in the past? If so, please explain what types of animals, when, and for how long. *

Do you own any pets currently?*

YesNo

Pets Names, Breed, Age, Sex

How long have you had your current pets?

Please describe your pet's personalities. Describe pet's disposition and behavior towards other cats.

Are you pets spayed/neutered?

YesNoOther

Are your cats FIV/FeLV tested?

YesNoUnknown

What is your cat's FIV/FelV status?

Are your pets up to date on their vaccines?

YesNoOther

Please provide your veterinarian's name, address and phone number:*

What type of food do you prefer to feed your pets? (Wet/ Dry, and Brand)

What kind of cat are you looking to adopt? And what made you want to adopt a cat?*

How long do you plan on having this cat?*

Would you prefer a declawed cat?*

YesNo

Will the cat(s) be allowed outside?*

YesNoOther

Would you prefer a cat who catches mice?*

YesNoOther

Will you travel with your cats?*

YesNoOther

Will you crate your pet?*

YesNoOther

How many hours per day would the pet be alone?*

Does your budget allow for the cost of maintaining of a pet and can you afford vet expenses? *

What would you estimate the cost of maintaining a pet to be per month?*

Under what Circumstances would you not be able to keep this pet. Check all that apply*

Please explain any further details regarding above question.

How would you deal with behavioral issues such as destructive behavior, bathroom accidents indoors, etc. in your pet?*

Have you ever declawed a cat before?*

YesNoOther

Will you ever declaw this cat?*

YesNoMaybeOther

Have you ever had to re home a pet? If so, how did you do so, and why?*

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter? Please explain. *

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

If you answered "Yes" please provide a detailed description:

Are you willing to allow a home visit by a representative?*

YesNoOther

If you have to leave town, emergently or planned, where would your pet stay? Give name of individual*

Relationship to you*

Their phone number*

Can we call this person to verify?*

YesNoOther

Please supply 2 personal references.

Reference #1 Name*

First NameLast Name

Reference #1 Phone Number*

Reference #2 Name*

First NameLast Name

Reference #2 Phone Number*

Is there any other information that you wish to provide?

Please scan or take a photo of your Driver's License, or Photo ID and upload below. *

By clicking the submit button, I understand that an application, interview, and home visit DO NOT guarantee adoption.
By clicking the submit button, I agree to Cocoa & Friends Cat Rescue adoption process, will undergo a homecheck, and interview at the discretion of Cocoa & Friends Cat Rescue.
By clicking the submit button, I understand Cocoa & Friends Cat Rescue will check my references including veterinary and personal.
By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Cocoa & Friends Cat Rescue and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Cocoa & Friends Cat Rescue BY EMAIL and BY TELEPHONE and provide a 14 day period to allow Cocoa & Friends Cat Rescue to make arrangents for my pet to be taken back into rescue.
By clicking the submit button, I agree to indemnify and hold harmless Cocoa & Friends Cat Rescue against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By clicking the submit button, I understand that Cocoa & Friends Cat Rescue will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Cocoa & Friends Cat Rescue and provide transport to where Cocoa & Friends Cat Rescue deems appropriate.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature*