First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*

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County*

Email*

Home Phone*

Work Phone

x

Cell Phone

Alt Email

Which animal are you interested in?

Choose an animal:AbbieAlexanderBabesBeasleyBellaBoo BooBowBryan AdamsBubblesBuffyCampbellCarmelloChance zombieCJD.C.DeitzDuganElla MaeEllieEllis QuinnForrestFoxFredFrittyGarfieldGidgetJaxLewisMarvinMoonbeamMoxie SueNodRoxyScooterSebastianShadowSimonSkyyTiggerTommyTucker CanexWatson JamesWilma JeanWobblesWolfieWyattWynkenYork

Are there any other animals of interest should the above animal be unavailable?

List the name and ages of all members of your household*

Do all members of your household agree to bringing in another pet?*

Choose one:NoYes

Have your children lived with pets in the past?*

Please list all animals currently in your home. Include whether they are spayed or neutered, up to date on vaccinations, gender, age, type of animal and breed?*

Have you ever applied for or adopted any animal from any rescue, shelter or this rescue?

Have you ever been denied previously for a animal when applying to another rescue or shelter? Reason?*

Please list all previously owned animals and what happened to them? (Gave away, accident, illness, etc)*

Are there any situations that would cause you to return or give away your animal?*

Are you aware and agreeable to our no declaw policy?

How many hours a day will your pet be without human companionship? Please explain:*

What is the name and age of the primary caretaker for the cat?*

Do any members of your household have allergies to dogs/cats?*

What kind of housing do you live in?*

Choose one:ApartmentTownhouseDuplexRanchTwo StoryMobile Home

Do you own or rent?*

Please list your current veterinarian including their phone number and name on account. Also, please call you vet to let them know we will be contacting them for a veterinary reference. *

If you rent, we MUST contact the owner to obtain permission for this cat to live in your home. Property's owner name & phone number:

How much are you willing to spend on medical bills for your cat?*

Choose one:Less than $500$500-$1000More than $1000

What would you do if vet bills went over this amount?*

Do you use Flea & Tick Meds and Heartworm meds? If so, what kind?*

Do you plan to move any time soon?*

Where will the cat have access to?

Where in your home will the cat NOT be allowed?*

What precautions would you take to properly introduce your new cat into your home, or to your current animals?*

If a behavior or disciplinary problem arises, what steps will you take to correct it?

What would your plans be to care for the cat should you have to go away for an extended period of time or vacation?*

Are you prepared to car for this cat for 15-20 years depending on the age of the cat your interested in adopting?

Please list name and Phone number of 3 personal references.*