Rescue Cat Adoption Application

Cat Adoption Application
Underground Community Cat Rescue is an all-volunteer, non-profit, cat welfare organization dedicated to the rescue and placement of stray, neglected and abused cats. Underground Community Cat Rescue is completely funded through fundraising efforts and public donations. All of our cats and kittens are cared for by foster homes and receive complete medical care, which includes worming, vaccinations, spaying/neutering prior to their adoption.

This questionnaire is designed to help UCCR and yourself determine if a specific cat is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. UCCR reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions.
Applicant Information
Name of the cat/kitten you are interested in:*
Your full name:*
Your age:*
Street Address:*
City, State, Zip*
Home Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:
Employer:
Character reference and phone number:
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow cats?

YesNo
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?

YesNo
Does anyone in your home have allergies to cats or have asthma?*

YesNo
Current/Previous Pet Information
Other pets and ages in household
Are all your pets are spayed/neutered?
Have you adopted from an animal welfare group before?

YesNo
If yes, what group?
Have you ever given up a pet?

YesNo
If yes, what were the circumstances?
Provide the name and phone number of your current and/or previous veterinarian or clinic:
May we contact your veterinarian?

YesNo
New Pet Information
Briefly describe your average day and how your cat/kitten would fit into it*
Do you understand that a cat can be an 18 year commitment, and can cost $100 - $300 per year to care for?*

YesNo
Share any additional comments your may have.
Adopter agrees and understands that all UCCR adopted tame cats/kittens are indoor only. All adopted cats are fullly vaccinated, fixed and vet records are provided if pertains to your cat/kitten.

I understand that I assume full responsibility for the welfare of this pet from the date of adoption.

By signing and submitting, you swear that all information given is truthful and complete.
Signature and Date
Should be Empty:

Cat Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information