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Adoption Application
VALLEY STREAM CAT RESCUE INC.
PRE ADOPTION APPLICATION
Name: ____________________________
Address: ____________________________
Phone: (home): ___________________
(work): __________________
(cell): __________________
Best time to reach you: _____________
Place of Employment: ________________________________________________________________
Address:__________________________________________Phone:___________________________
Your Date of Birth: _____________ Are you Married, Single, Co-habitating? ____________________
Number and Ages of Children: _________________________________________________________
If co-habitating and living arrangements change, who would keep the cat? ______________________
Do you own or rent a home or apartment? (describe)______________________________________
Do you live with a relative? (describe) ___________________________________________________
How many people live with you? ___________________ How many rooms do you have? _________
Landlord's Name and Phone: __________________________________________________________
Are you permitted to have pets? _______________________
Do you have strong screens on your windows? _______________ Screen/Storm Doors?___________
Does anyone in your house have allergies to cats? _________________________________________
Why do you want a cat? (companionship/ for a child/ as a mouser) ___________________________
Who is the cat for? (yourself/ family/ as a gift (if so for whom and is it a surprise?) _______________
Where will the cat spend its time? (Indoors/Outdoors) (Mostly in) (Mostly Out) (In only) (Out only)
(Describe fully) _____________________________________________________________________
Where does your current (or previous) cat spend its time? __________________________________
Will the cat be allowed outside? ________________________________________________________
List the number, types, ages and sex of pets currently in your home:
Cat: ______________________________ Dog: __________________ Other: _________________
Name and Address of Veterinarian: _____________________________________________________
____________________________ Phone: ___________________
Have your pets been vaccinated this year? __________ Date of last vet appt: ___________________
Do your animals see the vet for annual check-ups? ________________________________________
Do you declaw your cats? __________ Do you spay/neuter your cats? ________________________
Have your cats been tested for Feline Leukemia and Aids? ____________ Date of test: ___________
Can you afford an unanticipated vet bill of $500? (easily/ with difficulty/not at all)? _______________
How many hours a day will the cat be left alone? ______________ Do you drive? ________________
Do you use a cat carrier when taking the cat out? _______________
Do you own a carrier? _________
Do you have all the necessary equipment for adopting a cat or would you have to purchase it?
________________________________________________________
Who would care for your cat if you were unable? __________________________________________
If something should happen to you, do you have provisions for the future care of the cat? (describe)
__________________________________________________________________________________
When you go on vacation who cares for the cat? (neighbor/board the cat/take with you/leave in someone else's home/ leave alone with food and water) Describe: ____________________________
__________________________________________________________________________________
What type of food do you feed? (Brands) Dry: _________________ Canned: _________________
Cats can live as long as 15 to 20 years, do you plan on caring for one that long? _________________
Are you accepting of a cat's behavior in the house (jumping, playing, etc.)? _____________________
Are you accepting of a young kitten's behavior in the house? (playing, crying, being awake at night, scratching, needing constant attention? _________________________________________________
Is there any further info you can provide to assist us in adopting to you? ______________________
__________________________________________________________________________________
__________________________________________________________________________________
Personal reference(other than family member) ____________________________________________
Address: ___________________________________ Phone: _______________________
Cat you wish to adopt:________________________________________________________________
Would you consider adopting a pair if you currently have no cats? ____________________________
Why did you choose this cat/kitten? _____________________________________________________
Valley Stream Cat Rescue Inc. is a non-profit organization staffed entirely by volunteers. We are committed to
serving the best interests of the cats in our care. We, therefore, reserve the right to select the home that best meets the needs of each individual cat. Thank you for considering a VSCR cat for adoption.
Prospective adopters must be at least 24 years of age.
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