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Name *
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Address 1
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Address 2
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City
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State
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Zip Code
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Best Contact Number
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e-mail address
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What type of housing do you have?
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Own
Rent
Live with
parents
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Are you employed?
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YES
NO
Student
Retired
Stay at home
parent
Other
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Are you 18 or older?
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YES
NO
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Are you adopting this cat for yourself?
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YES
NO
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Does every person in the household agree to having a cat in your home?
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YES
NO
UNSURE
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How many adults are in the
household?
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How many children in the household and their ages?
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Who will be responsible for feeding, grooming, and cleaning the litter box?
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Myself
My Spouse
My Children
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Who would care for the kitty if
something were to happen to you?
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Cats lick their fur to clean themselves; this produces CAT DANDER to which many people are ALLERGIC. Have you or anyone in your household ever
experienced an allergic reaction to a cat
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YES
NO
UNSURE
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Have you ever owned a cat before?
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YES
NO
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Cats currently in your household?
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If you currently have cats, what are ages of cats? Are they spayed or neutered? Are they current on vaccinations?
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Have your cats been tested for
Feline Leukemia
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YES
NO
UNSURE
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Are your cats declawed?
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NO
YES-ALL
YES-FRONT ONLY
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Dogs currently in your household?
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If you currently have dogs, are they spayed or neutered? Are they current on vaccinations? Have they been around cats before?
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What is the name and number of your veterinarian?
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Have you ever given away an animal to an individual, family, shelter, or rescue group?
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YES
NO
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If yes, where and why?
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Why do you want this cat?
(check all that apply)
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Companion for
family
Companion
for other animal
office cat
mouser
other
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Do you have a certain type of cat in mind? (check all that apply)
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kitten
adult
senior
male
female
short-hair
medium-hair
long-hair
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If you have a specific cat in mind, provide name here:
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Where will your cat live?
(check all that apply)
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in home
office
outdoors
in a barn
in a garage
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Scratching is a typical cat/kitten behavior. How will you deal with this?
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If you had to move, what would you do with this cat?
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Under what circumstances would you give up your pet? (check all that apply)
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divorce
does not
like family member
aggression
allergies
litter box
issues
moving
behavior
problems
a new baby in
house
scratching
furniture
change in
lifestyle
does not like
other pets
Medical
Problems w/ the Pet
child lost
interest
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Cats can live 15-20 years. Are you willing to take responsibility for this cat for that length of time?
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YES
NO
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The average expense for a cat is $600-$1000 a year, not including unexpected veterinary bills. Can you afford to make such a monetary
commitment to this cat?
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YES
NO
Unsure
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You understand that you are interested in adopting a rescued animal and that previous medical history is not known. You understand that FCCR
cannot guarantee the health of these animals.
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YES
NO
Unsure
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CheckboxesYou understand that your are interested in adopting a rescued animal and that previous medical history is not known. You understand
that FCCR cannot guarantee health of these animals.
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Yes
No
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Any other information you would like to let us know:
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Image Verification
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