First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

How did you hear about Kitty Chicks Rescue?

Which cat or kitten are you interested in? *
Choose an animal: Almond Joy Bam Bam Bean Casper CiCi Clemson Cleo Jiggs Lydia Milly Reeses Simon Skittles Smitty Spike Sprout Twix Tyson

Why do you want to adopt?*

Do you currently have any cats?*
Choose one: Yes No

If yes, how many?

Have you had cats in the past?*
Choose one: Yes No

If yes, how long did they live?

Were they indoor or outdoor? *

Were they declawed? *
Choose one: Yes No

Were they spay/neutered?*
Choose one: Yes No

Do you currently have any dogs?*
Choose one: Yes No

If yes, how many?

Are they cat friendly?
Choose one: Yes No

Do you plan on declawing your cat? *
Choose one: Yes No

Do you plan on keeping your cat indoors?*
Choose one: Yes No

Are you 18 or older?*
Choose one: Yes No

How many adults live in the household?*

How many children live in the household?*

Ages of children?

If over 18 are you a college student?
Choose one: Yes No

If yes, are you living on or off campus?

Is anyone allergic to cats?*
Choose one: Yes No

Where do you live? *
Choose one: Apartment Condo House

Do you rent or own?*

If you rent does your landlord allow pets?
Choose one: Yes No

If yes, how many?

Please provide 3-character references who know about your experience with pets. Please do not list immediate family or anyone living in the household adopting the pet. References can be extended family, friends, co-workers, etc.

Character Reference 1 – Name:*

Relationship to Applicant:*

Phone Number:*

Character Reference 2 – Name:*

Relationship to Applicant:*

Phone Number:*

Character Reference 3 – Name: *

Relationship to Applicant:*

Phone Number: *

Veterinary Name:

Vet Phone number:

Address:

**If this is your first pet and you have no vet established, you will be required to get one set up and have your pet seen within the first week or you will forfeit your adoption and the pet must be returned to us. We will follow-up with the chosen vet after your initial appointment**