Cat Adoption Application

Today's Date *

Cat name: *

Adopter's First Name *

Adopter's Last Name *

Email Address *

Street Address *

City *

State (Please Select) *

Zip Code *

Contact Number *

How did you hear about us? *

Occupation/Employer *

Weekly Hours Worked *

How Long at Current Job *

Do ALL adults in your household agree to this adoption? *

Names and Ages of Household Members *

Do you have other pets? *

Describe your other pets, including name, age, sex, and whether they are neutered/spayed

Have you ever owned any animal other than the one listed above?

If Yes, what kind of animal and when?

What happened to the animal?

What is the name and phone number of your current veterinarian? *

A personal reference is required. (not living with you) Please list the name and relationship of a reference we may contact. Please let them know we will be calling. *

Reference Phone number *

Reference email *

How long have you resided in your current location? *

Do you own or rent your residence? *

What kind of type of residence do you live in? *

If renting, are animals allowed on premise?

If renting, please list name of landlord and phone number

If you are moving soon, what will happen to your pet? *

Please select one of the following: *

I am looking to adopt for the following reason(s): *

Will the adopted cat live primarily inside or outside? *

Have you ever applied or adopted from another group?

If yes, what organization or person did you work with in the last 5 years?

Have you ever been declined for adoption ? *

If yes, what was the reason?

Have you ever given up or turned in an animal to a rescue or shelter? If so, why? *

What is your general philosophy on vet care? *

Will you have the cat declawed?

Which of the following reasons would you consider giving up your pet? *

If you cannot keep your cat, you must return him/her to Shelter2Rescue Coalition. Do you agree? *

Shelter2Rescue Coalition and the representatives of the rescue reserve the right to call and verify care of the adopted pet with the veterinarian? *

I hereby agree to hold Shelter2Rescue Coalition, Inc and it's representatives harmless against any and all claims, damages, cost, expenses, or other items pertaining to cat that is being adopted, or anything resulting from or caused by the adopted cat. *

Full Name *