CARING HEARTS ADOPTION APPLICATION

 Name of Cat   ___________________________    Date_________________________________

Your Name ____________________________________________________________________

Address  _________________________________________________________________

City  ________________________________State     ____ ZIP___________

Home Phone     _________________________      Work Phone

Cell Phone__________________________

EMAIL_____________________________________________

Employer   ___________________________Address    __________________________________

Occupation ______________________________How long at this company?_______________

Do you live in a: House___Apartment__Condo___Duplex___Townhouse___Trailer___

Do you: Own___Rent___                How long have you lived there?________________________

If you rent, when is your lease expiring?___________Landlord's phone number_______________

How many people live in your household? Adults:_____children  (under 18) _________________

Does any member of your family/household have any known allergies to animals? ______Yes ______No

Is everyone in your household in favor of adopting a pet?  ________Yes    ________ No

How many pets live in your house currently? _________Cats ________Dogs  ________Other

Tell us about your current pets. (Type, age, inside or outside)

_____________________________________________________________________________

_____________________________________________________________________________

Are your animals spayed/neutered?   __________Yes    _________No

Where will this pet reside? _______Inside only _______Outside ______Garage/Barn ____ inside/outside equally

Please list any pets you no longer own and explain what happened to them. _______________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Who is your veterinarian?____________________Vet's Phone #:_________________________

May we contact your veterinarian as a reference? Yes___ No____

How much do you plan to spend yearly to feed, vaccinate and provide medical care for your pet?_________________

Do you plan to declaw your cat/kitten? ________Yes _________No

If yes, why?___________________________________________________________________

How much time will you allow for this cat to adjust to its new home, environment, and present pets and lifestyle?___ _____________________________________________________

What would constitute a reason for giving up your pet?____________________________________________________

Will you agree to a scheduled home follow-up visit after adoption? Yes___No___

Please print off this application, complete it and email it to: caringheartsrescue@yahoo.com

Completion of the application does not obligate you to adopt. It helps us match you to your purfect furrever furrend.