Bronx Tails Cat Rescue Feline Adoption Application
Completion of this form does not guarantee adoption of a cat. We have the right to refuse any adoption based upon the best interest of the animals we serve.

In order to be considered as an adopter you must:
• Be 21 years of age or older
• Have identification showing your present address
• Have the consent of your landlord or building management
• Be willing to pay the adoption fee of $125 per cat
• Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet for the duration of its lifetime.

Name of cat(s) you are interested in: *
Your answer
Your Name *
Your answer
Today's date: *
MM
/
DD
/
YYYY
Address (street address, city, state, zip) *
Your answer
Phone 1: *
Your answer
Phone 2:
Your answer
Email: *
Your answer
Driver's License #: *
Your answer
Your age is .... *
Is this animal for yourself and / or your family? *
Your answer
How long have you lived at your present address? *
Your answer
Do you rent or own? *
If renting, are pets allowed? *
Are you moving any time soon? *
Type of dwelling you live in: *
How many adults do you live with? *
Your answer
How many children do you live with? Please provide their ages. *
Your answer
Does any member of your household have an allergy to cats? *
Your answer
Who will be responsible for feeding, housebreaking, and training your pet(s)? *
Your answer
How many hours per day will he cat(s) be WITHOUT human companionship? *
Your answer
Do you go away often? *
Your answer
Who will take care of your pet(s) when you are away? *
Your answer
The cat(s) will be kept ... *
Do you have a yard? *
IF you have a yard, is it fenced?
Do you have screens on all your windows? *
Do you have a balcony, porch, or terrace? *
Will you make a commitment to choose only housing that allows pets? *
Your answer
Will you declaw your cat(s)? *
Your answer
Will you keep your pet(s) up to date on vaccinations? *
Your answer
Are you able to pay an average of $200 per year in basic veterinary maintenance? *
If your cat(s) becomes ill or injured, are you willing to pay at least $300 to $500 in medical costs? *
Your answer
Are you willing to take responsibility for your pet(s) for the next 10 to 20 years? *
Your answer
Are your pets current on their vaccinations? *
Your answer
Were / will your cats be tested for Feline Leukemia? *
Your answer
Were / will your cats be tested for Feline Aids Virus? *
Your answer
Do you have a dog / cat door? *
Please list your veterinarian, their address, and phone number. *
Your answer
Would you agree to an announced visit and / or call? *
What is the main reason for wanting a cat today? *
Your answer
Please list all the animals you have had in the last 5 years.
For EVERY pet you have had in the last 5 years, be sure to list:
a) Type of Animal
b) Age
c) Sex
d) Whether they are spayed or neutered
e) (For cats) Whether they are declawed, and if so, which claws (front and back or just front?)
f) Where they are / were kept (i.e. indoor, outdoor, or a combination of the two, etc)
g) Where are they now
Pet 1 Details:
Your answer
Pet 2 Details:
Your answer
Pet 3 Details:
Your answer
Pet 4 Details:
Your answer
Pet 5 Details:
Your answer
Pet 6 Details:
Your answer
Please list the details of your employment:
Name of employer(s): *
Your answer
Address / work location: *
Your answer
Work phone number: *
Your answer
Work email:
Your answer
Your position / title? *
Your answer
How long have you worked at this company? *
Your answer
Please give 2 personal references, including name, address, phone number, and relation to self.
Personal Reference 1: *
Your answer
Personal Reference 2: *
Your answer
Agreement.
I verify that the information supplied by me on this form is true and correct. I understand that if this document contains any false or incorrect information, as determined by BRONX TAILS CAT RESCUE, I will be obligated to immediately surrender the cat to BRONX TAILS CAT RESCUE. *
Thank you!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms