All 4 the Love of Cats Animal Rescue

All 4 the Love of Cats Animal Rescue P.O. Box 1113 Palatine, IL 60078-1113 Phone: 847-302-6410 FELINE ADOPTION APPLICATION www.all4theloveofcats.com

Pet’s Name______ID#______Date______Time______Counselor______Please print and complete this form. All questions must be answered to be considered for adopting! Last Name______First______MI______Maiden Name______Spouse/Roommate______First______MI______Maiden Name______Address______City______State______Zip______Length of time at address ______Previous Address______City______State______Zip______Length of time at address______Current Phone______Work Phone______Spouse Work Phone ______Email address______Driver’s Lic. #______Spouse/Roommate Driver’s Lic. # ______Do you own______Rent______Landlord’s Name & Phone # ______No. of adults in household______No. of children in household______Ages of children ______Are all members of your household here with you today? Yes______No______Who is missing? List name[s], age and relationship ______

Employment: Company ______Phone______Shift______How long employed there ? ______Spouse/Roommate______Phone______Shift______How long employed there? ______

Have you ever trained or had a kitten before: Yes______No______Do you have a scratching post: Yes______No______Have you ever trained or had an adult cat? Yes______No______Will this be your first feline? Yes______No______Do you have a carrying crate? Yes______No______Do you have any allergies to pets? Yes______No______Have you ever had to get rid of a pet? Yes______No______If yes, please explain. ______Who will be responsible for feeding, training, and vet care? ______How many hours will the cat be left alone each day? ______Where will the cat be housed: (Circle one) Indoors only Outdoors only In & Out Barn Other, explain ______Do you want a declawed feline? Yes______No______If one is not available, would you declaw? Yes______No______Why to you want a pet? (Circle all that apply) Companion Companion for other Pet Mouser For a child Gift Other, explain ______

Form revised by: C. Fitzgerald for Sarah Cole on 8/7/08 @ 1:30PM Current Pets (List only canines and felines) Write none if you currently have no pets. How long have Kept Dog/C Name Age you had the inside or What vet to you use with this pet? at animal? outside?

Past Pets List all canines and felines owned in the last 10 years. Write none if you have had no pets in the last 10 years. Purchased/received from How long did Kept Dog/C Name where and at what age? you have your inside or Where is pet at pet? outside? now?

List all veterinarians you used with past pets: (Include clinic name, phone number and city) ______PLEASE READ AND SIGN: I certify that all the information I have given on this application is true. I understand that any false information, unanswered questions, and omitted information will result in immediate rejection.

Signature:______Spouse signature______

Date:______Date______Office Use Only Please to not write in the space below: Application reviewed by: Date:

Potential Adopter interviewed by: Date:

Form revised by: C. Fitzgerald for Sarah Cole on 8/7/08 @ 1:30PM Application approved for: Date:

Application rejected by: Reason: ID#

Form revised by: C. Fitzgerald for Sarah Cole on 8/7/08 @ 1:30PM