WHISKER RESCUE ADOPTION APPLICATION
YOUR NAME:
ADDRESS:
CITY:
STATE:
ZIP:
HOME PHONE:
CELL:
EMAIL ADDRESS:
DATE OF BIRTH?
(YOU MUST BE 21 OR OLDER TO ADOPT)
ARE YOU EMPLOYED?
Yes
Retired
Student
Other
HOW DID YOU HEAR ABOUT US?
PLEASE LIST 2 REFERENCES--ONLY ONE CAN BE A FAMILY MEMBER
REFERENCE 1
NAME:
PHONE #:
RELATIONSHIP:
REFERENCE 2
NAME:
PHONE #:
RELATIONSHIP:
WHICH ANIMAL ARE YOU APPLYING FOR?
WHY HAVE YOU CHOSEN THIS ANIMAL?
ARE YOU PREPARED FOR A 15-20 YEAR COMMITMENT WITH THIS ANIMAL?
Yes
No
Housing
WHAT TYPE OF HOME DO YOU LIVE IN?
HOUSE
TOWNHOUSE
APARTMENT/CONDO
MOBILE
DUPLEX
OTHER
HOW LONG HAVE YOU LIVED THERE?
DO YOU PERSONALLY OWN OR RENT THE PROPERTY LISTED ABOVE? IF NOT, PLEASE EXPLAIN.
IF RENTING, PLEASE PROVIDE LANDLORD'S NAME AND PHONE #.
YOU MUST SUPPLY A COPY OF YOUR RENTAL AGREEMENT AT TIME OF ADOPTION.
DO YOU PLAN ON MOVING IN THE NEAR FUTURE?
IF YOU MOVE, WILL YOU MAKE ARRANGMENTS FOR THE ANIMAL TO COME WITH YOU?
HOW MANY ADULTS LIVE IN THE HOME?
HOW MANY CHILDREN UNDER THE AGE OF 18 LIVE IN THE HOME? LIST THEIR AGES:
DOES ANYONE IN THE HOUSE HAVE ALLERGIES TO ANIMALS?
ANIMAL HISTORY
LIST THE ANIMALS YOU CURRENTLY HAVE INCLUDING THEIR NAME, BREED, AGE, GENDER, AND ANY HEALTH ISSUES:
LIST OTHER ANIMALS YOU HAVE HAD IN YOUR LIFE INCLUDING THEIR BREED, YEARS LIVED, AND WHAT HAPPENED TO THEM:
HAVE YOUR CATS BEEN TESTED FOR FELINE LEUKEMIA AND FIV?
WHAT WERE THE RESULTS?
DO YOU PLAN TO DECLAW THIS CAT/KITTEN?
Yes
No
WHAT WILL YOU SUPPLY FOR THIS CAT/KITTEN TO SCRATCH ON?
DO YOU AGREE TO KEEP THIS CAT/KITTEN STRICTLY INDOORS?
Yes
No
ARE ALL OF YOUR ANIMALS SPAYED AND/OR NEUTERED?
ARE ALL OF YOUR ANIMALS UP TO DATE ON VACCINES?
Yes
No
IF NO, PLEASE EXPLAIN:
PLEASE LIST THE NAME & NUMBER OF YOUR VETERINARIAN CLINIC SO WE CAN VERIFY THAT YOUR PETS ARE CURRENT ON VACCINES AND SPAYED/NEUTERED:
HAVE YOU EVER HAD ONE OF YOUR ANIMALS GET SICK?
Yes
No
WHAT WAS WRONG AND EXPLAIN WHAT YOU DID TO HELP HIM OR HER THROUGH IT?
WHAT WOULD BE THE MAXIMUM YOU WOULD SPEND ON AN UNEXPECTED MEDICAL BILL AND/OR EMERGENCY BILL?
$100
$500
$1000
$ THE SKY'S THE LIMIT!
HAVE YOU EVER HAD TO GIVE UP YOUR ANIMAL??
Yes
No
IF YES, WHY?
WHERE DID THE ANIMAL GO?
HOW MUCH TIME WILL THE ANIMAL SPEND ALONE DURING THE DAY?
WHERE WILL THE ANIMAL BE KEPT WHEN YOU ARE NOT AT HOME?
WHAT BRAND OF DRY FOOD DO YOU FEED OR PLAN TO FEED YOUR ANIMAL(S)?
WHAT BRAND OF CANNED FOOD DO YOU FEED OR PLAN TO FEED YOUR ANIMAL(S)
PET BEHAVIOR
IT WILL TAKE THIS CAT APPROXIMATELY 2 DAYS TO BECOME FAMILIAR WITH ITS NEW HOME AND ABOUT 2 WEEKS, SOMETIMES MORE, TO BECOME COMFORTABLE WITH THE FAMILY AND OTHER PETS. ARE YOU PREPARED TO GIVE THIS ANIMAL THE NECESSARY TIME IT NEEDS TO ADJUST TO HIS/HER NEW HOME AND LIFE?
Yes
No
ARE YOU WILLING TO WORK WITH THIS ANIMAL TO CORRECT BEHAVIORAL PROBLEMS, IF THEY ARISE, SUCH AS REFUSING TO USE THE LITTERBOX OR DESTRUCTIVE CLAWING?
Yes
No
***** I CERTIFY THAT ALL THE INFORMATION I HAVE PROVIDED IS COMPLETE AND TRUE AND I AGREE TO COMPLY WITH THE TERMS OF THIS ADOPTION. I UNDERSTAND THAT FILLING THIS FORM OUT DOES NOT GUARANTEE THAT I WILL BE ADOPTING THIS ANIMAL.
You must agree before submitting.
Submit Application
After submitting this form, you will be contacted by a Whisker Rescue Representative within 1 to 3 days. With kittens it can sometimes be longer due to the number of applications we receive.
