Dockery's Amazing Rescues Adoption Form

Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at this address?:*
Cell Phone Number
Name and Address of Employer:
Up until what time of night can we contact you via phone?*
E-mail*
example@example.com
Are you able to afford the adoption fee of $200?*

YesNo
Are you planning on moving within the next 6 months?*

YesNo
If yes, what are your plans for your pets if you move?
Are you 25 years of age or older?*

YesNo
Do you own your own home?*

YesNo
If no, name and phone # of landlord:
Type of Dwelling:*
Name and age of ALL occupants in household (including yourself):*
If no children, do you plan on having children or will children be visiting the household frequently?*

YesNo
What is your reason for wanting to adopt a cat?*

HousepetMouse PatrolCompanionCompanion for petGiftOther
If other, please explain:
How many total hours will your new pet be left alone during the day?*
If adopting a kitten, where would the kitten be kept when alone?
Are you planning on declawing your new cat or kitten?*

YesNoMaybe
Are your current cats declawed?*

YesNoN/A
Are any members of your household allergic to animals?*

YesNo
If yes, please describe:
Who will have chief responsibility for the care of your new pet?*
Over the past 5 years, how many pets have you owned? (Include current pets)*
List each individually including breed, age, still living with you? (if not, why?)
Have you and your spouse (if applicable) ever owned a cat together?*

YesNoN/A
If yes, when?
Have you ever lost or given away a pet?*

YesNo
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?*

YesNoN/A
If no, please explain:
Are your present pets spayed or neutered?*

YesNoN/A
If no, please explain.
Are you financially prepared to spend for routine/emergency medical care, licensing, etc?*
What plans do you have for your new pet when you are on vacation?*
Which cat(s) on our website are you interested in?*
Age of cat you would consider adopting: (check all that apply)*

KittenYoungAdultSpecial NeedsSenior
Can/Will you provide your cat with monthly flea/tick prevention?*

YesNo
What brand of cat food do you plan on feeding your new cat?*
Is your entire immediate family in agreement with the decision to bring a new pet into your home?*

YesNo
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)?*

YesNo
Why are you choosing to adopt vs. buying from a pet store or breeder?*
Where will your cat spend most of his/her time?*
Where will your cat eat?*
Where will your cat sleep?*
Please provide a personal reference that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.
Reference #1*
First and Last Name & Relationship to Self
Reference # 1 Phone Number*
If there is anything else you think we should know, please note it here.
Please remember, we are very busy and it may take a few days or more for us to get back to you.
Thank you so much for wanting to rescue a cat!!
Should be Empty:

Please provide a personal reference that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.

Please remember, we are very busy and it may take a few days or more for us to get back to you.

Thank you so much for wanting to rescue a cat!!