Pet Rescue Adoption Application Form

Pet Rescue Adoption Application Form
Name of the Pet*
Applicant Details
Name*

First NameLast Name
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Mobile)*
Format: (000) 000-0000.
Phone Number (Work)*
Format: (000) 000-0000.
Phone Number (Home)*
Format: (000) 000-0000.
E-mail*
example@example.com
Single Family HomeDuplex / TwinCondo / TownhomeTrailerApartmentOther
If you rent, Does your Landlord permit pets?*
How long have you lived there?*
Are you planning on moving in the next 6 months?*
Are you active military or other job subject to relocation?*
If you moved or there was a change in life circumstances, would the pets go with you?*
If an allergy developed, are you willing to take steps to keep your pet?*
How many adults in your household?*
How many children in your household? What are their ages?*
Would your pet's primary caretaker be adult? Teen? Child? *
Is everyone in the household supportive of the decision to adopt a new pet?*
Have you ever had a pet get lost and what steps did you take?*
Have you ever had a pet injured by a moving vehicle? How will you prevent this from happening again?*
YesNo
Tell us about the other household pets (species, age, spay/neuter, where kept, time owned.*
YesNoOther
Where does the pet stay (be confined) while you are out?*
How do you discipline your pets and why? (describe)*
Number of hours (average) pet(s) spends alone*
Please address these questions: Are you willing to provide annual vaccinations and medical care? How would you handle any problem such as scratching furniture, urinating on floors, furniture, rugs; stops using the litter box; chewing.
Required information
How will you manage care if you have to go away on vacation, business, or longer?
Required information
YesNo
Veterinarian’s name*
Clinic Name*
Clinic's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Clinic's Telephone*
Format: (000) 000-0000.
Please add at least two references*
I confirm that all information supplied above is correct and accurate.
Newly adopted kittens and cats may be shy and fearful at first, and may run from strangers, loud noises, your other pets and anything they do not feel confident about. By signing this application, you are affirming that you are willing to take the necessary steps and devote the time and patience to ensure this new cat is introduced to the family in a manner which will instill confidence and comfort. This form is not only to provide proper education on the commitment of owning a new pet, but to ensure that you understand the full responsibility involved with your new pet.
Signature
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Pet Rescue Adoption Application Form

Applicant Details