Bast Cat and Kitten Rescue Adoption Application

Bast Cat and Kitten Rescue

For the love of little paws
Full Name *

First Name Middle Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

How long at this address?: *
Home Phone Number

Area Code Phone Number
Cell Phone Number

Area Code Phone Number
Name and Address of Employer:
Work Phone Number

Area Code Phone Number
Up until what time of night can we contact you via phone? *
E-mail *
example@example.com
Are you able to afford the adoption fee of $50? *

Yes No
How were you referred to The Last Resort Rescue? *
Are you planning on moving within the next 6 months? *

Yes No
If yes, what are your plans for your pets if you move?
Are you 21 years of age or older? *

Yes No
Birth Date *

Month Day Year
Do you own your own home? *

Yes No
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? *

Yes No
What is your reason for wanting to adopt a cat? *

Housepet Mouse Patrol Companion Companion for pet Gift Other
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? *

Yes No Maybe
Are your current cats declawed? *

Yes No N/A
Are any members of your household allergic to animals? *

Yes No
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? *

Yes No N/A
If yes, when?
Have you ever lost or given away a pet? *

Yes No
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? *

Yes No N/A
If no, please explain:
Are your present pets spayed or neutered? *

Yes No N/A
If no, please explain.
Were your previous pets spayed or neutered? *

Yes No N/A
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? *
Which cat(s) on our website are you interested in? *
Age of cat you would consider adopting: (check all that apply) *

Kitten Young Adult Special Needs Senior
Can/Will you provide your cat with monthly flea/tick prevention? *

Yes No
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? *

Contact a Professional Use a book Personal Knowledge Other
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)? *

Move box to new location Try a different litter Clean box more often Have cat examined by vet Use a cat door Return Cat None Other
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? *

Yes No
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)? *

Yes No
Are you willing to allow BC&K Rescue to make future visits to your home? *

Yes No
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care? *

Yes No
If yes, please describe:
Have you ever adopted or tried to adopt a pet before? If yes, fill out info below. *

Yes No
Rescue Information

Name of Rescue Contact Name
Rescue's Phone Number

Area Code Phone Number
Why are you choosing to adopt vs. buying from a pet store or breeder? *
If other, please explain:
Where will your cat spend most of his/her time? *
If you selected outdoor, would your cat be supervised?

Yes No
Where will your cat eat? *
Where will your cat sleep? *
Please provide 3 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 Code Phone Number
Reference #2 *
First and Last Name & Relationship to Self
Reference #2 Phone Number *

Area Code Phone Number
Reference #3 *
First and Last Name & Relationship to Self
Reference # 3 Phone Number *

Area Code Phone Number
If there is anything else you think we should know, please note it here.
Please remember, we are all volunteers and it may take approximately a week or more for us to get back to you.
Thank you so much for wanting to rescue a cat!!
Should be Empty:

Bast Cat and Kitten Rescue

Please remember, we are all volunteers and it may take approximately a week or more for us to get back to you.

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