iRescue Cat/Kitten Application

Full Name*

First NameLast Name

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Name of the cat you're interested in adopting*

What interests you in this particular cat?*

Indoor onlyOutdoor onlyIndoor and outdoorOther

Are there any characteristics you are not looking for?*

Are you adopting a cat for your home, business, or for someone else?*

Please list all persons living with you, their ages, their relationship to you and whether employed. If any household member does not want to adopt a cat, please explain. *

YesNo

Briefly describe your residence (ie, 1 bedroom apt, townhouse, etc)*

How many years/months have you lived at this residence?*

YesNo

If yes, please list species, age, breed, sex of each animal. Are they spayed/neutered? Have any cats been feline combo tested (FIV/FeLV)? Have any dogs been introduced to cats before?*

Have you ever taken a pet to a shelter? If yes, please explain why and when.*

YesNo

Who is your local veterinarian? Include name, address and telephone number*

YesNo

If you became ill, disabled or died, who will care for your cat(s)? Please provide name, address and phone no. Also, you can always calliRescue, and we will take your cat back, no questions asked.*

Please write your name below if you agree with the following statement: I certify that the above information is true and accurate to the best of my knowledge, and I understand that my completion of this form in no way obligates iRescue to adopt a cat to me. I further understand that in order to complete the adoption process,iRescue or a representative known and trusted by them will conduct a home visit. *

Name*

First NameLast Name

iRescue cat/kitten application for adoption