Cat's name: Where did you find this cat? Please link to Facebook post, website post, etc.
Your Information
First and Last Name
Street Address
City State Zip County
E-mail Address
Main Phone
Work Phone
Place of employment
Type of housing Single family home Apartment Townhome Dorm Farm Mobile home Other If Other, specify here:
Rent or own? Rent Own
Landlord's name Landlord's phone number
How long have you lived at this current address?
Are you in the process of moving, or anticipate moving in the next few months?
If you ever move, have you considered that another place may not allow pets? What will you do if this happens?
Adoption Information
What is your past and/or current experience with cats? 1st time owner Have had 1 or 2 cats as an adult Had a cat as a child Experienced in resolving behavior issues
If you selected "experienced in resolving behavior issues," please explain:
Have you adopted with Animal Rescue Relay before? Yes No
Who will care for this cat primarily? (feeding, playtime, vet visits)
What are some reasons you would relinquish this cat back to ARR?
Previous and current pet information
Have you ever had a pet: Run away Get hit by a car Die in your care Kept as an outdoor pet If so, please explain: Have you ever surrended any pet to a private rescue or individual? Yes No If yes, please explain the circumstances:
Current Pets
Please list your current pets and include the following information. Are your current animals up to date on vaccines?
Previous Pets
Please list your previous pets and include the following information.
Are you prepared for veterinary care expenses? Yes No
Who is your veterinarian?
Would the records be under another name other than the one provided on the front of the application? If so, please provide the name.
Do you have other veterinarians that may have records for your current or past pets? Yes No
If so, please provide their name and contact information.
Household Information
Please describe your household: Active Noisy Quiet Average Busy Other If you selected Other, please describe here:
Please list the names and ages of ALL people living in the home and their relationship to you (spouse, partner, roommate, daughter, etc). Failure to fully disclose this information will result in immediate adoption denial.
Do children (other than immediate family) ever visit your home? Yes No If yes, how often? Age(s) of the children?
Does anyone in the household have allergies to any kind of animals? Yes No If yes, have they consulted with their doctor about getting an animal? If yes, are they taking medication?
Has anyone in your household ever been convicted of animal cruelty, neglect, or abandonment? Yes No
Provide three references that we can contact
Personal Reference #1 Name Phone
Personal Reference #2 Name Phone
Personal Reference #3 Name Phone
New pet information
Please understand that it may take a new cat 2 weeks or more to adjust to a new home and/or to other pets and visitors.
Where will you keep this cat? (Check ALL that apply) Free run of the house Crate in house Inside cat Outside cat Inside/outside In garage Yard with a fence Basement Other (please explain) If Other, explain here:
Where will the cat be kept during the day? At night?
Why do you want a cat? (Check ALL that apply) Mouser/barn cat Breeding Companionship Children Travel companion Gift for a friend or relative Other (please explain) If Other, explain here:
Do you plan on declawing the cat? Yes No If Yes, why?
It is unrealistic to expect a child of any age to assume complete responsibility for an animal. Ultimately the adult(s) of the household are responsible for the complete care of the animals in the home. Are you prepared to take all responsibility for this animal should your child/ren become disinterested? Yes No
Please give careful consideration to adopting this animal. Animals are not toys or short term commitment, they do require daily attention. Make sure your lifestyle allows time, emotional commitment, and financial responsibility this animal will need over its life span.
It is the responsibility of Animal Rescue Relay to place this animal in an environment compatible with its needs and to ensure the adoption is in the best interest of both the animal and applicant. Animal Rescue Relay reserves the right to deny any applicant.
** Animal Rescue Relay may follow up by phone or in person on any adoption to ensure compliance with the adoption contract. **
Enter your full name and date to certify that you have read the above information and that all information you have given is true and accurate and is subject to verification by Animal Rescue Relay. Any falsification may result in the nullification of an adoption.
Full name Date