Community Cat Rescue is committed to placing homeless cats and kittens in homes compatible with your and the animal's needs. Please answer all questions to assist us in our match. Your application will be reviewed by our Adoption Committee.
Kitten/Cat Name:
Description:
About You
Name:
First:
Last:
Address:
City:
State:
Zip:
Home phone:
Work phone:
Cell phone:
Email:
How long have you lived at this address?
What type is your residence?
House
Apartment
Condominium
Other
Do you
Rent
Own
Does your rental agreement allow pets?
Yes
No
Landlord's name:
Landlord's phone:
How heavy is traffic on this street?
Light
Medium
Heavy
Do your windows have screens?
Yes
No
How many adults at this residence?
How many children?
Ages of children?
Does anyone in the home have allergies to cats?
Yes
No
About the Cat
Who is your veterinarian/veterinary clinic?
Veterinarian:
Phone:
Who will be primary caretaker for the cat(s)?
Who will take care of the cat(s) when you are away from home?
How often does the primary caretaker travel?
How many hours a day will the cat(s) be alone?
Where will the cat(s) be when alone?
Where will the cat(s) be when you are at home during the day?
Where will the cat(s) be when you are home at night?
The cat(s) will be
Indoor only
Outdoor only
Indoor/Outdoor
Do you anticipate declawing the cat(s)?
Yes
No
About Your Other Pets
What pets do you currently have? Please include their ages and how long you have had them.
What pets have you had previously? Please include their ages and how long you had them.
What happened to them?
Have you ever had a declawed cat?
Yes
No
Have you ever surrendered one of your pets to a shelter?
Yes
No
Please explain:
Have you ever lost a pet or had one die of accident or injury?
Yes
No
Have you ever had a pet hit by a car?
Yes
No
Have you ever nursed a sick animal?
Yes
No
Please describe the illness and the care provided.
Notes
Is there anything else you'd like to tell us?
Feedback
How did you find out about Community Cat Rescue?
Have you attended a Community Cat Rescue Adoption Fair?
Yes
No
Had you already decided to adopt a kitten/cat before attending the adoption fair?
Yes
No
Signature
I certify that the above information is true and understand that misrepresentations may result in the cancellation of the adoption.
Signature:
Date:
