Kitties for Keeps Rescue Adoption Application Form

Date

Which Cat are you interested in?

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number

Area CodePhone Number

Home Phone Number

Area CodePhone Number

Work Phone Number

Area CodePhone Number

E-mail

Spouse or Other Adult in Household

First NameLast Name

Spouse or Other Adult Phone Number:

Area CodePhone Number

Name of Employer:

Length of Time at Current Employer:

Are you Over 21?:

Type of residence:

Condo and Townhome owners: Do you have HOA pet restrictions on number of pets?

Length of Time at Current Residence:

Do you:

If Renting, Does your lease allow pets?

If renting, Please provide landlords name and phone number

Do you have plans to move in the near future?

How Many Adults In the Household?

How Many Children in the Household?

Ages of Children in Household

Does Anyone In Your Household have Allergies or Asthma?

Other

Is anyone allergic to animals?

Other

Does Everyone in the Household Agree to adopting a cat?

Is this Cat a Gift:

Should you become incapacitated and unable to care for your newly adopted cat/kitten or if you must move and cannot find a residence that allows pets, what will you do with the cat?

Is it OK if we visit your home to see how and where the animal will be living?

Please list all animals you currently own or have owned in the past 5 years.

Pet 1: Type of Pet, Name, Age, Sex, Spayed/Neutered, Still own?

Pet 2: Type of Pet, Name, Age, Sex, Spayed/Neutered, Still own?

Pet 3: Type of Pet, Name, Age, Sex, Spayed/Neutered, Still own?

Pet 4: Type of Pet, Name, Age, Sex, Spayed/Neutered, Still own?

Pet 5 Type of Pet, Name, Age, Sex, Spayed/Neutered, Still own?

Have your current cats been tested for Feline Leukemia and FIV?

Are any of your current cats declawed?

Where are your current pets kept?

Are all of your current pets up to date with Vaccines? If no, please explain.

Have you ever had a pet:

Please Note: We will be contacting your veterinarian for a reference. You will need to contact them to authorize the release of basic information to us, If we cannot verify your information within 48 hours, we will not be able to approve your application.

Your Current Veterinarian Information: Clinic Name, Address, Phone Number

If you do not have any current pets, and do not have a veterinarian you have visited, please supply us with 3 Personal references that are not related to you.

Personal Reference 1: Name, Phone number, Address, Relationship

Personal Reference 2: Name, Phone number, Address, Relationship

Personal Reference 3: Name, Phone number, Address, Relationship

Why do you want to adopt a cat / kitten?

Have you ever cared for a cat / kitten before?

If unwanted behavioral problems arise, what steps will you take to correct them?

Do you have a room with a door where your new cat can be kept while transitioning into his/her new home?

What precautions would you take to properly introduce a new cat to your home if you have other pets (dog, bird, rabbit, other cat, etc.)

How many hours will the cat be left alone during the day?

Where will the cat be kept when nobody is home?

Do you plan on declawing your new cat?

And why?

What are your thoughts on declawing? Under what conditions would you consider this procedure?

Who will be primarily responsible for the care of this cat?

How much would you estimate supplies to be for 1 year?

How much would you estimate veterinary care to be for 1 year?

Are you able to afford unexpected medical bills for a cat?

Do you think your pet should have a yearly physical exam?

Do you believe you can provide a good home for your pet for its entire lifetime which could be up to 20 years or more?

Have you ever taken any of your pets to another organization or given up to a friend or relative? If Yes, please explain below

If yes, please explain circumstances

N/A if no

If your application for adoption is approved by Kitties for Keeps Rescue Inc. where do you plan on keeping the pet? (Check all that apply)

Will your cat be indoors, outdoors, or both?

Where will your new cat sleep?

Do you believe in spaying and neutering animals? And Why?

Do you think an animal should have at least one litter before being spayed?

Have you ever applied for, or adopted a pet from, Kitties for Keeps Rescue Inc or any other rescue or shelter in the past?

If yes, which rescue or shelter, and when?

What is your experience with cats?

Are you a U.S. Veteran? ( Proof Required )

Any other comments or information you would like us to know in considering your adoption application?

IF YOU HAVE LEFT ANY QUESTIONS BLANK, YOUR APPLICATION WILL NOT BE PROCESSED AND YOU WILL RECIEVE AN EMAIL TO RESUBMIT!

By submitting this form I certify that the information I have given is true and that any misrepresentation of facts may result in my losing the privilege of adopting. This cat will reside in my home as a pet. I will provide this cat with adequate food, water, shelter, training, affection and medical care. If the cat is not spayed/neutered at the time of adoption due to age, I agree to spay or neuter the cat as soon as medically necessary in accordance with the adoption contract and forward evidence of such to Kitties for Keeps Rescue by the date requested. I am in full agreement with these terms. Kitties For Keeps Rescue is in no way liable or responsible for any damage, accident or injury. I understand that there is a NON-REFUNDABLE adoption fee to help offset veterinary expenses. Further, I give permission to Kitties for Keeps Rescue, Inc. to contact my current veterinarian and/or references (as appropriate).

Kitties For Keeps Rescue reserves the right to refuse or deny any application and/or adoption without explanation.

Approved applications are valid for 30 days; any approved applicant will need to re-apply if they do not adopt a pet within that time period. Kitties for Keeps Rescue also reserves the right to rescind approval at any time.

e-Signature

Date

KittiesForKeepsRescue.com

KittiesForKeepsRescue@gmail.com