CAT ADOPTION APPLICATION FORM

CAT ADOPTION APPLICATION FORM

Up Manhattan Cat Rescue Positive Action For Neighborhood Cats
We request the following information so that we can assist you in the selection of a new cat. This form is designed to help you find the cat most compatible with your lifestyle. Please hand form to volunteer or email to info@upcatrescue.org if completing online.

Are you interested in a specific cat(s)? Y/N Cat Name(s):
If you are interested in specific cat(s) Please add name(s) below
Name of applicant
Date

MonthDayYear
Date
Address

Street address

Street Address Line 2

CityState

Zip
Phone
Email
example@example.com
How long have you lived at this address
What is your age range?

Under 23 Years23-55 years55-65 yearsOver 65 years
What kind of pets have you had in the past
Which of these do you still have Include age sex and breed
What happened to the pets you no longer have
If you have pets, will they adjust to a new cat in the house?

YesNoUnsure/Don't know
Have you ever had a pet euthanized

YesNo
If yes please explain
Have you ever turned a pet into a shelter

YesNo
If yes please explain
How many adults are in your family
If there are children in your home please note age(s) below
Where do you live?

HouseApartment/CondoOther
Do you own or rent your home?

OwnRent
If you rent, may we contact the owner to obtain permission for this cat to live in your home?

YesNoCan we discuss this further?
What is your current occupation
Does your job require extensive travel? Y/N

YesNo
Do you have screens on your windoes?

YesNo
Name of employer
Phone
City & State
If you go away for a few days or on a vacation who will take care of the cat
What arrangements will you make for the care of your pets in case of an emergency or if you become unable to care for himher
Are you aware that cats can live 15 to 20 years and are you willing to take responsibility for this cat for the next 10 to 20 years? Y/N

YesNo
Are you willing to have a representative of Up Manhattan Cat Rescue come to see where the cat will be lliving?

YesNoCan we discuss this further?
If you move, It is important that you take your cat(s) with you. Please confirm if this is acceptable to you?

YesNo
Please provide three personal references. Only one can be an immediate family member:
Reference 1 Name
Phone
Email
example@example.com
Reference 2 Name
Phone
Email
example@example.com
Reference 3 Name
Phone
Email
example@example.com
Thank you for considering giving a cat a forever home!

NYS Rescue Registry #579 www.upcatrescue.org Email: info@upcatrescue.org
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