Cat Adoption Form

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Full Name

First Name

Last Name

Address

Street Address

City

State / Province

ZIP / Postal Code

How long at this address?:

Home Phone Number

Cell Phone Number

Name and Address of Employer:

Work Phone Number

Up until what time of night can we contact you via phone?

E-mail

Are you able to afford the adoption fee of $100?

Yes No

How were you referred to The Last Resort Rescue?

Are you planning on moving within the next 6 months?

Yes No

If yes, what are your plans for your pets if you move?

Are you 25 years of age or older?

Yes No

Birth Date

Do you own your own home?

Yes No

If no, name and phone # of landlord:

Type of Dwelling:

Name and age of ALL occupants in household (including yourself):

If no children, do you plan on having children or will children be visiting the household frequently?

Yes No

What is your reason for wanting to adopt a cat?

If other, please explain:

How many total hours will your new pet be left alone during the day?

If adopting a kitten, where would the kitten be kept when alone?

Are you planning on declawing your new cat or kitten?

Yes No

Are your current cats declawed?

Yes No

Are any members of your household allergic to animals?

Yes No

If yes, please describe:

Who will have chief responsibility for the care of your new pet?

Over the past 5 years, how many pets have you owned? (Include current pets)

List each individually including breed, age, still living with you? (if not, why?)

Have you and your spouse (if applicable) ever owned a cat together?

Yes No

If yes, when?

Have you ever lost or given away a pet?

Yes No

If you currently own a dog or cat, how does he/she react to new cats?

Are your present pets up-to-date on their annual vaccines?

Yes No

If no, please explain:

Are your present pets spayed or neutered?

Yes No

If no, please explain.

Were your previous pets spayed or neutered?

Yes No

If no, please explain.

How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?

What plans do you have for your new pet when you are on vacation?

Which cat(s) on our website are you interested in?

Age of cat you would consider adopting: (check all that apply)

Kitten (0-6 months) Young (6 months-2 years) Adult (2-7 years) Senior (7+ years)

Can/Will you provide your cat with monthly flea/tick prevention?

Yes No

Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER: PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE PERMISSION TO RELEASE INFORMATION AS MANY WILL NOT GIVE US A REFERENCE WITHOUT YOUR CALL, AND WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION.

If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?

Positive Reinforcement Training Consult a Veterinarian Consult an Animal Behaviorist Other

If other, please explain:

What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?

Change Litter Type Change Litter Box Type/Location Consult a Veterinarian Other

If other, please explain:

What brand of cat food do you plan on feeding your new cat?

Is your entire immediate family in agreement with the decision to bring a new pet into your home?

Yes No

If anyone is NOT, please explain:

Are you prepared to commit to a pet for 15 - 20 years (average life span)?

Yes No

Are you willing to allow TLR to make future visits to your home?

Yes No

Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?

Yes No

If yes, please describe:

Have you ever adopted or tried to adopt a pet before? If yes, fill out info below.

Yes No

Rescue Information

First Name

Last Name

Rescue's Phone Number

Why are you choosing to adopt vs. buying from a pet store or breeder?

If other, please explain:

Where will your cat spend most of his/her time?

If you selected outdoor, would your cat be supervised?

Yes No

Where will your cat eat?

Where will your cat sleep?

Reference #1

Reference # 1 Phone Number

Reference #2

Reference #2 Phone Number

Reference #3

Reference # 3 Phone Number

If there is anything else you think we should know, please note it here.

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