Rose's Refuge
Adoption application
Full Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State
Post Code
E-mail
*
Are you 18 years of age or older?
*
Yes
No
Birth Date
*
Please select a month
January
February
March
April
May
June
July
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October
November
December
Month
Please select a day
1
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31
Day
Please select a year
2026
2025
2024
2023
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Year
Do you own your own home?
*
Yes
No
If not, what is your landlord's policy on pets?:
Type of Dwelling:
*
Please Select
House
Apartment
Condo
Mobile Home
Are you planning on moving within the next 6 months?
*
Yes
No
If yes, what are your plans for your pets if you move?
What is your reason for wanting to adopt a cat?
*
Companion
Companion for pet
Other
If other, please explain:
If adopting a kitten, where would the kitten be kept when alone?
Are you planning on declawing your new cat or kitten?
*
Yes
No
Maybe
Are any members of your household allergic to animals?
*
Yes
No
Are your current cats declawed?
*
Yes
No
N/A
If yes, please describe:
Over the past 5 years, how many pets have you owned? (Include current pets)
*
Please Select
0
1
2
3
4
5
6+
Please list breed, age, if they're still living with you? (if not, why?)
Have you ever lost or given away a pet?
*
Yes
No
If you currently own a dog or cat, how does he/she react to new cats?
Are your present pets up-to-date on their annual vaccines?
*
Yes
No
N/A
If no, please explain:
Are your present pets spayed or neutered?
*
Yes
No
N/A
If no, please explain.
Were your previous pets spayed or neutered?
*
Yes
No
N/A
If no, please explain.
Can/Will you provide your cat with monthly flea/tick prevention?
*
Yes
No
If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?
*
Contact a Professional
Use a book
Personal Knowledge
Other
If other, please explain:
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?
*
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
If other, please explain:
What brand of cat food do you plan on feeding your new cat?
*
Are you prepared to commit to a pet for 15 - 20 years (average life span)?
*
Yes
No
Where will your cat spend most of his/her time?
*
Please Select
Indoors Only
Outdoors Only
Indoors and Outdoors
Barn Cat
Basement/Garage
Confined
If you selected outdoor, would your cat be supervised?
Yes
No
If there is anything else you think we should know, please note it here.
Submit Adoption Application
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