CCR Adoption Application Name of cat(s) interested in:
Choose an animal:
Cleo
Coastal Kitties
Gigi
Goldie
Halo
Imperial Officers
Jimmy
Kip
Lilith
Lola
LOP-EAR BUNNY! Pavlova
Moonbeam & Sunshine
Nino
Popcorn
Remington
Smudgie the Stray
Sydney
Zing
Married *
Choose one:
Yes
No
Name of spouse, significant other or roommate(s) (please list all adult residents): *
Place of Employment: *
Are you or your spouse in the military? *
Choose one:
Spouse
Self
Neither
EOS/PRD
Will the animal be kept inside or outside *
Choose one:
Inside Only
Outside Only
Mostly Inside
Mostly Outside
What traits are you looking for in a pet
Is this animal a gift for someone? *
Choose one:
Yes
No
Who is the cat a gift for? *
Why are you interested in adopting a pet at this time *
How did you hear about us *
Do you own or rent your home *
Choose one:
Rent
Own
In what type of home do you live *
Choose one:
Single Family
Duplex
Apartment
Townhouse
Condominium
Mobile Home
Military Housing
How long have you lived at your current address? *
If you rent, have you received the approval of your landlord to have an animal *
Choose one:
Yes
No
NA
If you rent, please enter your landlord's name and phone number *
How many people reside in your household *
How many children *
Choose one:
None
1
2
3
4
5
6
7
8
9
10
If children, what are their ages? *
• Have you or any member of your household ever experienced allergies or asthma? *
Do you have a balcony? *
Choose one:
Yes
No
NA
Will the cat be allowed on the balcony *
Do you have a pet door? *
Choose one:
Yes
No
Where does the pet door go? *
Do you have unscreened windows? *
Choose one:
Yes
No
Will the cat be allowed access to the entire house or only part of the house? Which part? Why? *
Do you have coyotes in your neighborhood *
Choose one:
Yes
No
What predators do you have in your neighborhood? *
• Do you object to our organization doing a home check before placing the cat(s) with you? *
Choose one:
Yes
No
Have you ever had cats? *
Choose one:
Yes
No
How many cats do you have now? *
Choose one:
None
1
2
3
4
5
6
7
8
9
10
If you have a cat(s), what are their ages? *
Where will the litter box be kept? *
Have you ever given up a pet? If yes, please explain *
How many dogs do you have now? *
Choose one:
None
1
2
3
4
5
6
7
8
9
10
If you have a dog(s), what are their ages? *
What are the breeds of dogs you now have? *
Will the cats interact with the dogs? *
Choose one:
Yes
No
Do you keep identification on your pets at all times? *
Choose one:
Yes
No
Where will the animal sleep *
Have your pets had any serious illnesses? Describe. *
Veterinarian's Name and Phone Number *
For cats only: Are you planning to declaw either traditional or laser? *
Choose one:
Yes
No
If yes, why and what is your understanding of the surgical procedure? *
What will you do if future medical treatment for the cat is over $500? *
Are your other pets spayed / neutered? *
Choose one:
Yes
No
Are they up to date with vaccinations? *
Choose one:
Yes
No
What will you do with the cat when you go on vacation? *
What will you do if the cat becomes destructive in the house? *
What will you do with the cat if something happens to you where you will no longer be able to care for the cat? *
What will you do with the cat if you must move to a place that doesn’t allow pets? *
How much time will you be spending at home with your cat? *
Who will be responsible for the daily care and maintenance of your cat? *
Other?
Under what circumstances would you NOT keep the cat? SELECT ALL THAT APPLY
Have you applied with any other rescue *
Choose one:
Yes
No
I am aware that the potential commitment of time, patience and expense needed for a cat can span 20 years or more. I understand that cats need affection, attention and understanding and that they can get sick and require expensive medical treatment. I understand that I may need to adjust my lifestyle to accommodate my new pet. I am ready to make that commitment. Please enter your initials *
I certify that the information entered on this applicant is true. Enter your name and date *
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