Cat Adoption Application - Kitten Korner Rescue, Inc.

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Cat Adoption Questionnaire for Meet and Greet Appointment

Date *

Cat names you want to meet and possibly adopt *

Cat's Age *

Cat's Gender *

Cat's Description *

Cat's Current Foster Family *

This can be found on the cat's page on our website

Applicant's Name *

First

Last

Address *

City *

Zip code *

Do you... *

Own
Rent

Home phone *

Cell phone *

Email *

# of adults living at home *

# of children *

Ages of children *

Do you have pets now *

Yes
No

What type of pets *

How many pets *

How long have you had your pets *

Are they spayed/neutered *

Yes
No

Are your pets up to date on vaccines *

Yes
No

Are your cats tested fro FeLv/FIV *

Yes
No

Your current veterinarian office *

Veterinarian office address *

Veterinarian office phone number *

Sign your name - Authorization to release veterinary records - I hereby certify that I am the owner (pet parent) or authorized agent of the pet parent of the above described pet. Further, I hereby request and authorize this veterinarian to release the requested medical information for my pets to Kitten Korner Rescue, Inc. I release the veterinarian and staff from any legal responsibility or liability for the release of information to the extent indicated as authorized herein. This authorization expires 90 dates from the date of signature. I understand I may revoke this authorization, but the revocation may not be applied retroactively once the information specified herein has been released. *

Are you considering having your cat/kitten declawed *

Yes
No

If yes, please explain why... *

Will your cat be... *

Indoor only
Indoor/outdoor

If you rent, we need to contact your landlord for adoption approval prior to releasing a cat or kitten... *

Landlord's name

Landlord's phone number

I understand that I will have to have the adopted kitten(s) spayed/neutered at my own expense, if not previously done at time of adoption. *

I agree
I disagree

I agree that the above described animal is being adopted by me as a per solely for myself and my immediate family. *

I agree
I disagree

I agree that I will not sell, give away or otherwise dispose of said animal to any person(s), dealer, retailer, auction, institute or any other entity for any reason. *

I agree
I disagree

If at a later date I am unable or unwilling to keep this pet, I agree to first contact Kitten Korner Rescue to give them the option of reclaiming said pet at no charge. *

I agree
I disagree

I agree to give a reasonable amount of time for reclaiming arrangements to be made. *

I agree
I disagree

I hereby agree to care for the pet in a humane and responsible manner and to provide it with clean and adequate shelter, food and veterinary care.

I agree
I disagree

I agree that cat shall reside inside my home and shall not be able to roam freely outside. *

I agree
I disagree

I agree that I will not declaw the cat or kitten, as it is considered inhumane by the ASPCA. *

Yes
No

I agree to the adoption fee of $175, which helps to cover the expense of raising and caring for the cat . *

I agree
I disagree

Included in the fee is a spay/neuter deposit of $50, which can be refunded after your kitten(s) is fixed and proof is provided. All of part of spay/neuter fee can be donated to Kitten Korner. *

I agree
I disagree

Adoption fee is not refundable after 14 days. *

I agree
I disagree

I agree that Kitten Korner makes no representations or warranties, expressed or implied, about cat's temperament or health. *

I agree
I disagree

Kitten Korner is hereby absolved from any liability for future illnesses, damages or injuries caused by cat. *

I agree
I disagree

I understand and agree that current foster and Kitten Korner gives no guarantees, expressed or implied, of the sustainability of the cat to the adopter and his family. *

I agree
Second Choice

I certify that all statements on this agreement are true and correct *

I agree
I disagree

I agree that Kitten Korner has the right to confiscate the cat in the event that any statements made by me are found to be false. *

I agree
I disagree

I agree that Kitten Korner has the right to confiscate the cat in the event that my check for the adoption fee is returned for insufficient funds. *

I agree
I disagree

I understand that I will have to have the adopted kitten(s) spayed/neutered at my own expense, if not previously done at the time of adoption. *

I agree
I disagree

I have read and agree to all terms in this adoption application *

Type name

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Our fee is $175 per cat or kitten and can be paid at pick up with a check made out to Kitten Korner Rescue, Inc. or by using our online payment method.

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