Retired Queens Rescue Adoption Application

Retired Queens Rescue Adoption Application

Thank you so much for considering a rescue as your next family member. Please click the grey arrow after the Veterinarian details section in order to complete the application in full.
Applicant Information
Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Occupation
How long have you lived at your current address?
Household
Residence Type

Other
If Other, please specify
Do you rent or own your home?
If renting, has your landlord given permission to keep a cat?
Number of Household Members
Ages of All Household Members
Are all household members aware of and supportive of the adoption?
Are there any pet allergies in the household?
If yes, please explain the allergies
Pet History
Do you currently have any pets?
Current Pets
Please list any pets you have owned in the past and what happened to them.
Have you ever surrendered, rehomed, or euthanized a pet for non-medical reasons?
If yes, please explain.
Experience and Veterinary Care
Why are you interested in adopting a cat?
Are you financially prepared for routine and unexpected veterinary care?
Do you have a regular veterinarian?
- Care and Home Environment
- Vacation care plan
- Contact for behaviour difficulties
  
  First NameLast Name
- Where will the cat spend most of its time?
- Describe your home environment and daily routine
- Hours per day the cat will be left alone
- Where will the cat sleep?
- References
- Reference 1 Name
  
  First NameMiddle NameLast Name
- Reference 1 Relationship
- Reference 1 Email
  example@example.com
- Reference 1 Phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Reference 2 Name
  
  First NameMiddle NameLast Name
- Reference 2 Relationship
- Reference 2 Email
- Reference 2 Phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Additional Information
- Is there anything else you would like us to consider?
- Agreements and Signature
- Agreement
- Electronic Signature
  
  First NameLast Name
- Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Retired Queens Rescue Adoption Application

Applicant Information

Household

Pet History

Experience and Veterinary Care

Care and Home Environment

References

Additional Information

Agreements and Signature