Cat Adoption App

Cat Adoption Application
Cat Preference
Adopter's General Information
Your name*

First NameMiddle InitialLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Birth Date*

MonthDayYear
E-mail*
Occupation
Employer Name
Length of time at current employer:
Have you adopted from KQCR previously?

NoYes*
If yes, approximate date adopted

MonthDayYear
Property /Household Information
Residence

HouseDuplexApartmentCondoMobile Home
Occupancy

I ownI rent*I live with a parent or guardian
How long have you lived at this address?*
*If you rent, name of landlord/condo manager

First NameLast Name
Landlord Phone

Area CodePhone Number
Landlord Email
Other Residents

First NameLast Name
Names & ages of children (if applicable)
Does anyone in your home have allergies?

NoYes*
*If yes, who and what type of allergy?
Who is this pet for?*

MyselfMy FamilyRelativeFriend
Pet will be kept:*

IndoorsOutdoorsBoth indoors & outdoors (explain below)
Explain indoors & outdoors:
Pet Information:
Have you ever had a companion animal before?

NoYes
If yes, were you the primary caretaker?

No*Yes
*If no, who was?
Please list current and past pets you have own in the past ten years, indicating breed, gender, spayed, neutered, pet's age, if you still have them and if not why not?
List Pets Here
Veterinarian Information
Please list your current / previous veterinarian(s). WISH will contact them to verify your current pets are up to date on shots and altered; this is a requirement for new pet adoptions. Please call their office(s) to authorize release of information to Kitty Queen Cat Rescue. If you are planning to utilize another vet but are not currently a client, please note that information.
Veterinarian Name

First NameLast Name
Vet Clinic Name*
Vet Phone

Area CodePhone Number
Vet Email
Will you declaw the cat/kitten you would like to adopt?

NoYes, front paws only*N/A
Are you interested in receiving information on training your cat to use a scratching post?

NoYes
*Please note: by completing this form, I agree that I will NOT declaw this cat(s). KQCR does not allow paw declawing of any cat adopted from this organization. For more information on declawing alternatives, please visit our website.
In an average year, how much do you estimate spending for vet care?
In an average year, how much do you estimate spending for food, supplies, litter, toys, etc?
As your new cat transitions to your routine, it may take a month (or more) to adjust. Are you willing to devote time to the transition process?

NoYes
Additional Information
To meet a pet, a potential adopter should fill out the adoption application, meet the pet and have a compatibility interview. We give preference to adopters in the immediate area of Pittsburgh. We do not use a first-come, first-serve process and we decide who is going to be the best match for each pet. The process is intended to ensure a best-fit, long-term successful adoption for both the family and pet.

* If you rent, provide a copy of your lease and addendum allowing pets to KQCR
* By signing this adoption application, you agree to provide vaccinations, health check-ups and any additional veterinary care, by a qualified veterinarian, on a yearly basis.
* Your adoption fee is a donation to KQCR and is nonrefundable.
* When adopting a cat or kitten, you must bring a secure cat carrier along when picking up your new pet.

By signing this form, I/we acknowledge that the information on this form is true and correct. I/we agree to all provisions indicated on this form. I/we understand that any misrepresentation of fact may result in Kitty Queen Cat Rescue, Inc. refusing adoption privileges to me/us. If my/our request for adoption is approved and later Kitty Queen Cat Rescue, Inc. discovers the above information is not true or correct, this application becomes null and void. Because of my breach of contract, Kitty Queen Cat Rescue, Inc. reserves the right to remove the adopted pet from my home, and I will be held responsible for any associated legal costs incurred as part of said reclamation process. In order to ensure the best homes for our rescued pets, we reserve the right to deny any adoption application.
Full Name*
I acknowledge that I have read and fully understand the contract presented above and by entering my full name and pressing, "Sign Contract," I represent and warrant that I am the individual identified and I understand and agree to be bound by the legal contract set forth above.
How did you hear about us?

Word of mouthPetfinderWebsiteFacebookOther*
*Other
Thank you for applying to adopt a pet from WISH! Please allow 48-72 hours to process your application.
For Office Use Only
ApprovedNot approved*
*Reason
Staff/Volunteer Electronic Signature
MonthDayYear
Adoption Donation
Payment Method
Foster Home
KittyQueenCatRescue@gmail.com
Should be Empty:

Cat Adoption Application

Adopter's General Information

Property /Household Information

Pet Information:

Veterinarian Information

Additional Information

For Office Use Only

KittyQueenCatRescue@gmail.com