Adoption Application

Thank you for your interest in adopting a pet from Purrty Pawz Rescue Inc! Please read over carefully as you will be asked to sign this adoption application at the end. After completion, please email application and animal shot records to director@purrtypawzrescue.org. Please allow 24-48 hours to process your application.

Applicant Legal Name*

Email *

Cell Number*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information*

Describe your home's activity level*

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Are you currently employed?*

YesNo

Name of Employer*

For whom are you adopting a pet for?*

MyselfGift

Who will be responsible for the care of the pet?*

Where will the pet be kept?*

Indoor onlyIndoor / Outdoor

If you move, what will you do with the pet?*

Please List all People Living in the Household (Include Name and Age)*

Does anyone in your household have allergies to animals?*

YesNo

Are all members of your family agreeable to adopting a cat?*

YesNo

Have you or anyone in your household ever surrendered a pet to a shelter? Why? *

Have you ever had to rehome a pet? Why?*

Have you or anyone in your household ever been charged or convicted of an animal welfare law violation including but not limited to: neglect, cruelty, abandonment? *

Please List any Pets you have (Please include Name, Breed, Age, Altered, UTD Vaccines)*

Veterinarian You Use: Name, Address, Phone Number (Please call and give permission for Purrty Pawz to call to verify)*

Which cat are you interested in?*

Please list 2 personal references with names and phone numbers. We prefer it not to be all relatives. Are you ok with this?*

YesNo

Reference #1: Full Name*

Phone Number*

Reference #2: Full Name*

Phone Number *

By sending this electronically, I acknowledge that I have completely read this application and comprehend it fully.

I attest that all the above information in this adoption application is true, complete and accurate. I understand that any false or misleading information/statements will automatically disqualify me from adopting a pet from Purrty Pawz Rescue Inc.

Date*

MonthDayYear

Your name*