Cat Adoption App

Cat Preference

Your name *

First Name Middle Initial Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone

Area Code Phone Number

Cell Phone

Area Code Phone Number

Birth Date *

Month Day Year

E-mail *

Occupation

Employer Name

Length of time at current employer:

Have you adopted from KQCR previously?

No Yes*

If yes, approximate date adopted

Month Day Year Date Picker Icon

Residence

House Duplex Apartment Condo Mobile Home

Occupancy

I own I 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 Name Last Name

Landlord Phone

Area Code Phone Number

Landlord Email

Other Residents

First Name Last Name

Names & ages of children (if applicable)

Does anyone in your home have allergies?

No Yes*

*If yes, who and what type of allergy?

Who is this pet for? *

Myself My Family Relative Friend

Pet will be kept: *

Indoors Outdoors Both indoors & outdoors (explain below)

Explain indoors & outdoors:

Have you ever had a companion animal before?

No Yes

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

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 Name Last Name

Vet Clinic Name *

Vet Phone

Area Code Phone Number

Vet Email

Will you declaw the cat/kitten you would like to adopt?

No Yes, front paws only* N/A

Are you interested in receiving information on training your cat to use a scratching post?

No Yes

*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?

No Yes

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 mouth Petfinder Website Facebook Other*

*Other

Thank you for applying to adopt a pet from WISH! Please allow 48-72 hours to process your application.

Approved Not approved*

*Reason

Staff/Volunteer Electronic Signature

Month Day Year Date Picker Icon

Adoption Donation

Payment Method

Foster Home

Cat Adoption Application

Adopter's General Information

Property /Household Information

Pet Information:

Veterinarian Information

Additional Information

For Office Use Only

KittyQueenCatRescue@gmail.com