Name of Cat/Kitten: *
Your full name: *
Your age: *
Home address: *
City, State: *
Zip Code: *
Home phone: *
Cell phone: *
Work phone: *
E-mail Address: *
What is the best way to contact you? *
About your home: I live in a *
Do you: *
If renting, does your landlord allow pets?
Landord's name:
Landlord's phone number:
Do you have any plans to move in the next five years? *
How long have you lived at your present address: *
How many times have you moved in the last five years: *
What would you do if you moved to a residence where pets were not permitted? *
ABOUT YOUR FAMILY: How many adults live in your household? *
How many children live in your household? *
What are the childrens ages?
Are all members of your household in agreement about adopting a cat? *
For whom are you adopting this cat? *
Who will be the primary caregiver for this cat? *
Who will be financially responsible for this cat? *
Are you willing to have all members of your household meet a LCR representative to meet the cat that you are applying for? *
Do any members of your household have asthma, or have allergies to cats? *
Describe your household activity/noise level: *
How often do you travel" *
How will you care for your cat when you are traveling? *
In the event of an emergency, who would care for your cat or what arrangements would you make? *
How many hours would the cat be alone during the day? * 0 1 2 3 4 5 6 7 8 8+
ABOUT YOUR CURRENT ANIMALS: Please list all animals you currently own: Pet #1 - Name:
Pet #1 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #1 - Breed:
Pet #1 - Age:
Pet #1 - Sex: ------ Male Female
Is pet #1 Altered (Spayed/Neutered)? ------ Yes No
How long have you owned pet #1?
Are all of pet #1's vaccinations up to date? ------ Yes No
Pet #2 - Name:
Pet #2 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #2 - Breed:
Pet #2 - Age:
Pet #2 - Sex: ------ Male Female
Is pet #2 Altered (Spayed/Neutered)? ------ Yes No
How long have you owned pet #2?
Are all of pet #2's vaccinations up to date? ------ Yes No
Pet #3 - Name:
Pet #3 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #3 - Breed
Pet #3 - Age:
Pet #3 - Sex: ------ Male Female
Is pet #3 Altered (Spayed/Neutered)? ------ Yes No
How long have you owned pet #3?
Are all of pet #3's vaccinations up to date? ------ Yes No
Pet #4 - Name:
Pet #4 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #4 - Breed:
Pet #4 - Age:
Pet #4 - Sex: ------ Male Female
Is pet #4 Altered (Spayed/Neutered)? ------ Yes No
How long have you owned pet #4?
Are all of pet #4's vaccinations up to date? ------ Yes No
Pet #5 - Name:
Pet #5 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #5 - Breed:
Pet #5 - Age:
Pet #5 - Sex: ------ Male Female
Is pet #5 Altered (Spayed/Neutered)? ------ Yes No
How long have you owned pet #5?
Are all of pet #5's vaccinations up to date? ------ Yes No
MORE ABOUT YOUR CURRENT ANIMALS: If you have a cat, does it get along with other cats? * ------ Yes No N/A
Does you current cat go outside? * ------ Yes No N/A
If you have a dog, does it get along with cats? * ------ Yes No N/A
What veterinary hospital do you take your pet to (type N/A if you don't currently have pets)? *
Vet phone number (type N/A if you don't currently have a vet): *
Are you experiencing any difficulties with your current pets in terms of health or behavior? ------ Yes No
If yes, please describe:
Did you have any pets while you were growing up? * ------ Yes No
Have you had the experience of being a primary caregiver to a cat? * ------ Yes No
Have you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it? * ------ Yes No
Have you ever had an animal for a short period of time and it didn't work out? * ------ Yes No
Have you ever had an animal lost or stolen? * ------ Yes No
Have you ever had to retrieve your pet from a pound, shelter or animal control facility? * ------ Yes No
Have you ever had an animal die as a result of being hit by a car, being poisoned or from unknown causes? * ------ Yes No
Have you previously applied to adopt from Lucky Cat Rescue? * ------ Yes No
ANIMALS OWNED OVER THE PAST 10 YEARS: Please list all animals you have owned in the past 10 years, NOT including the pets that currently live with you? Pet #1 - Name:
Pet #1 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #1 - Breed:
Was pet #1 Altered (Spayed/Neutered)? ------ Yes No
How long did you own pet #1?
What happened to pet #1?
When did this happen?
Pet #2 - Name:
Pet #2 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #2 - Breed:
Was pet #2 Altered (Spayed/Neutered)? ------ Yes No
How long did you own pet #2?
What happened to pet #2?
When did this happen?
Pet #3 - Name:
Pet #3 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #3 - Breed:
Was pet #3 Altered (Spayed/Neutered)? ------ Yes No
How long did you own pet #3?
What happened to pet #3?
When did this happen?
Pet #4 - Name:
Pet #4 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #4 - Breed:
Was pet #4 Altered (Spayed/Neutered)? ------ Yes No
How long did you own pet #4?
What happened to pet #4?
When did this happen?
Pet #5 - Name:
Pet #5 - Species: ------ Cat Dog Bird Rabbit Guinea pig Ferret Chinchilla Hamster Rat/Mouse Snake Frog Lizard Fish Horse Other species
If other, please specify?
Pet #5 - Breed:
Was pet #5 Altered (Spayed/Neutered)? ------ Yes No
How long did you own pet #5?
What happened to pet #5?
When did this happen?
PLANS FOR YOUR NEW PET: The new cat will live: * ------ Indoor only Outdoor only Both indoor and outdoor Not sure yet
Where will the cat be when no one is home? * ------ Indoors Outdoors
Will the cat be allowed free roam of your home? * ------ Yes No
What is the name of the veterinary practice you you plan to use? *
Why do you want to adopt a cat/kitten? * ------ Companion Mouser Other
If other, please specify?
Type of cat desired (check all that apply): *
If other, please specify?
Desired tempemeant/personality (check all applicable): *
If other, please specify?
Are you aware that some cats require a period of weeks or even months to adjust to their new home/environment/ other pets? * ------ Yes No
Are you willing to allow for this adjustment period? * ------ Yes No
Are you willing to bring your pet to a veterinarian for yearly exams, and for vaccinations per your veterinarian's recommendations? * ------ Yes No
Are you willing to accept responsibility for this pet for the next 10 to 20 years or more? * ------ Yes No
What circumstances might justify giving up a cat? (Check all that apply)? *
If other, please specify?
If your new cat or kitten exhibits behavioral or adjustment issues, would you be willing to seek the advice of a LCR representatives? * ------ Yes No
Please share any kitty habits you cannot tolerate: (Check all that apply) *
If other, please specify?
Please share with us anything you would like us to know about the new cat or kitten that you would like to add to your family.
Would you be interested in learning about some of our special needs or long term resident cats who are in need of loving, forever homes? * ------ Yes No
Would you be willing to have an in-home visit by an LCR representative after you have adopted from us? * ------ Yes No
PERSONAL REFERENCES: Relatives not allowed. Personal Reference #1: *
Relationship with personal reference #1: *
Phone number of personal reference #1: *
Personal reference #2: *
Relationship with personal reference #2: *
Phone number of personal reference #2: *
Personal reference #3: *
Relationship with personal reference #3: *
Phone number of personal reference #3: *
The cat that you are applying for today will be a part of your family for the next 15 to 20 years. Each cat has its own distinct personality and preferences, some of which you can help shape, others which you cannot change. A pet makes considerable demands on your time and resources. Cat owners need to spend time cleaning litter boxes, socializing, grooming, feeding and playing with their cat each day. Cat that are shy or have not had much human contact need even more time and socialization. ARE YOU READY AND WILLING TO ACCEPT PERSONAL AND FINANCIAL RESPONSIBILITY OF OWNING A CAT? * * ------ Yes, I accept. No
Have you fully read and do you agree to Lucky Cat Rescues Adoption Guidelines? * ------ Yes No
I have read the application and have completed it honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after the adoption takes place, I understand that Lucky Cat Rescue, Inc. reserves the right to annul the adoption and reclaim the animal. I give Lucky Cat Rescue, Inc. permission to fully investigate the information provided as well as contact veterinarians and related officials. Do you accept Lucky Cat Rescue's above terms? * ------ Yes, I accept. I decline
I understand the adoption decision is dependent on many factors, including, but not limited to, the compatibility of the family and home to the individual animal. I understand it is Lucky Cat Rescue's prerogative to decide which home is most appropriate and that their decision is final. Unless otherwise indicated by Lucky Cat Rescue, Inc., I am free to apply under the application process again in the future. LUCKY CAT WILL CONTACT YOU WITHIN 7 DAYS IF YOUR APPLICATION HAS BEEN APPROVED. DO YOU ACCEPT THE ABOVE TERMS? * ------ Yes, I accept. I decline
Do you accept Lucky Cat Rescue's terms for application? * ------ Yes, I accept. I decline
* Required
