Axanar Animal Rescue Cat Adoption Form

Full Name

First NameLast Name
Which cat(s) are you interested in?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at this address?:
E-mail
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Up until what time of night can we contact you via phone?
Name and Address of Employer:
Work Phone Number

Area CodePhone Number
Are you able to afford the adoption fee of $125?
How were you referred to Axanar Animal Rescue
Are you planning on moving within the next 6 months?
If yes, what are your plans for your pets if you move?
Are you 25 years of age or older?
Birth Date

MonthDayYear
Do you own your own home?
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?
What is your reason for wanting to adopt a cat?
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?
Are your current cats declawed?
Are any members of your household allergic to animals?
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?
If yes, when?
Have you ever lost or given away a pet?
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?
If no, please explain:
Are your present pets spayed or neutered?
If no, please explain.
Were your previous pets spayed or neutered?
If no, please explain.
How much 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?
Age of cat you would consider adopting: (check all that apply)
Can/Will you provide your cat with monthly flea/tick prevention?
Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER: PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE PERMISSION TO RELEASE INFORMATION AS MANY WILL NOT GIVE US A REFERENCE W/OUT YOUR CALL, AND WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION.
If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?
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)?
If other, please explain:
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?
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)?
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?
If yes, please describe:
Have you ever adopted or tried to adopt a pet before? If yes, fill out info below.
Rescue Information

Name of RescueContact Name
Rescue's Phone Number

Area CodePhone Number
Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved. PLEASE BE AWARE: If your references are not easily reachable or do not reply in a timely manner, it will delay your application. If multiple references do not reply, your application will be filed on HOLD. Please choose your references carefully and be sure to list the correct contact numbers.
Reference #1
First and Last Name & Relationship to Self
Reference # 1 Phone Number

Area CodePhone Number
Reference #2
First and Last Name & Relationship to Self
Reference #2 Phone Number

Area CodePhone Number
If there is anything else you think we should know, please note it here.
Once we have received your application, you will receive an email confirmation within 24 hours.
Thank you so much for wanting to adopt a rescue cat!!
Should be Empty:

Once we have received your application, you will receive an email confirmation within 24 hours.

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