Adoption Application – Surfcat Rescue

First Name

Last Name

Home Phone

Work Phone

Cell Phone

Email Address

Date of Birth

Driver's License and State

Current Address

City

State

Zip

Do you have a veterinarian?

Yes

No

What type of cat are you looking for?

Your Household

Do you own or rent?

Own Rent

Spouse Name

(if applicable)

# of adults in home

# of children in home

Ages of children

What is your regular schedule?

How many hours are you away from home on weekdays and weekends?

Current pets

Please list type, age, whether neutered, current shots, temperament, behavioral problems, etc.

Where do your pets sleep?

Do your pets wear collars and have microchips?

Do your pets get along with other animals?

Yes

No

Sometimes

It's Complicated

Do your windows have screens?

Yes No

Do you have a balcony?

Yes No

Do you have a cat door?

Yes No

Does your neighborhood have predators, i.e. coyotes?

Yes

No

Is anyone in your home allergic to animals?

Yes No

Cat Care Information

Will the cats have the run of the whole house?

Yes No

If you own or previously owned cats, were any of them declawed?

Yes No

Are you planning on having this cat declawed?

Yes

No

Where will the cat(s) live?

Inside Outside Other

Who will be the primary caregiver for the cat?

What will you do:

When you go on vacation?

If it becomes destructive in the house?

If future treatment for the cat is over $100?

Under what circumstances would you NOT keep the cat?

Moving Family illness or death New Baby Divorce Does not get along with other pets Has Fleas Scratches You Other

Sign and Submit

I am aware that the potential commitment of time, patience and expense needed for a cat can span 20 years or more.
I understand that cats need affection, attention and understanding.
I understand that I may need to adjust my lifestyle to accommodate my new pet.
I understand that cats can get sick and may require expensive medical treatment.
I am ready to make a full commitment to the guardianship and care of a new cat(s).
THIS QUESTIONNAIRE BECOMES PART OF OUR CONTRACT AND RECORDS AND WILL NOT BE RETURNED TO YOU.

I have read the above and answered the question to the best of my knowledge.

Signature

type your full name

Date