Cat & Kitten Pet Rescue Pet Adoption Form

Full Name*

First NameLast Name

What is your cell number? *

E-mail*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birth Date*

MonthDayYear

What is your occupation? *

Do you own or rent your home?*

OwnRentOther

Type of Dwelling:

If renting, what is your landlord's policy on owning pets? Please provide your landlord's name and phone number. *

Please provide three references, their phone numbers, and authorization to call them. Thank you. *

Are you willing to allow one of our representatives to visit your home by appointment?*

Are any members of your household allergic to animals? If so, please explain. *

If adopting a kitten/cat, where would the kitten/cat be kept when alone?*

Over the past 5 years, how many pets have you owned? (Include current pets)*

Please list breed, age, if they're still living with you. (if not, why?)*

Have you ever lost or given away a pet?*

YesNo

If so, please explain. *

Are your present pets spayed or neutered and up-to-date on their annual vaccines?*

YesNoN/A

Are you able to afford medical care, proper diet, shelter, training, grooming, exercise, and long-term commitment for your new pet for 15 - 20 years (average lifespan)?*

YesNo

Do you have a veterinarian? if so, please provide his/her contact information.*

If you can no longer care for the animal due to long-term illness, hospitalization, death, etc., do you have a designated person that can take over the commitment of keeping your pet safe and care for it? Please list that person's name and contact info. By providing their contact info, you are also giving us authorization to speak with this individual. *

Please fill in the type of pet you're interested in and its name. *

Pet Adoption Application Form