Name* First Last Email* Spouse/Partner's Name :* First Last Home Address:* Street Address City State / Province / Region ZIP / Postal Code How long have you lived at this address?* Do you expect to move in the near future?* Home No.:Mobile No.:*Best Time to Call: Occupation: How long have you worked at your present job? Spouse/Partner's Occupation: How long has your spouse worked at his/her present job? Age, Sex, and Relationship of ALL Household Members, including yourself:*Who will primarily be responsible for this cat?Is this cat to be a gift?* Yes No Are all household members aware of your decision to acquire a cat?* Yes No How did you find out about our rescue program?* Family/Friend Facebook Twitter Search Engine Event/Pet Fair Veterinarian Office Name:* Veterinarian Office Phone Number (Please notify vet with your permission to release information):*Veterinarian Office Address:* Street Address City State / Province / Region ZIP / Postal Code List other veterinarians that you have used. Include the address, phone number, pet's name, and how long ago.Please give us the names and phone numbers of at least two references that we may contact (neighbors, trainers, breeders, etc. No family members, please.)*List all types, breeds, ages, and sexes of ALL animals currently in the household (indicate if spayed or neutered). Also, tell us how long you have owned each animal and where the animal is kept.*Have you ever given away, sold, or surrendered a pet before? If yes, give details.Are you interested in a specific adoptable cat? The cat will be:* Indoor only Indoor/Outdoor Outdoor only Please describe your neighborhood:* City Suburban Rural Please describe your home:* Single Family Home Apartment Condo Mobile Home Do you own or rent your home? (If you rent, a copy of the lease will be requested as well as your property management's name & phone number before the adoption can be finalized. If you own/rent a condo, please provide contact information for the condo association.)*Are you agreeable to returning the cat to BDR should some unforeseen circumstance arise where in you would no longer be able to keep or care for the cat?* Yes No NameThis field is for validation purposes and should be left unchanged.
