Really Great Cats Rescue, Inc.
5959 Lawton Avenue
Rock Hall, MD 21661
fax/tel: 410-639-7171

To fax this form call us at 410-639-7171 and we will turn on the fax.

Interviewed by: _________________________________ Animal: ____________________________________

Feline Adoption Application

Really Great Cats Rescue, Inc. (RGCR) reserves the right to refuse adoption to anyone who fails to comply with RGCR policies.
FAILURE TO PROVIDE CORRECT INFORMATION MAY WARRANT ADOPTION DENIAL.

I, ____________________________________HEREBY GIVE PERMISSION TO RGCR TO CONTACT MY VETERINARIAN TO OBTAIN INFORMATION ABOUT PAST AND PRESENT PETS. I ALSO AUTHORIZE RGCR TO VERIFY THE BELOW LISTED INFORMATION.

NAME (last) (first) (middle):________________________________________________________________
DATE:____/_____/____

SPOUSE/ROOMMATE:______________________________________________________________________
911/STREET ADDRESS:_____________________________________________________________________
MAILING ADDRESS:________________________________________________________________________ CITY:______________________________COUNTY:_________________STATE:___________ZIP:_________
HOME PHONE:__________________________________WORK PHONE:_____________________________
1. Is this your first experience with a cat? YES | NO
Please list your presently owned pets

2. Have you ever adopted from us in the past? YES | NO - (IF YES, WHEN?)______________________________________________________________________

3. You want to adopt a pet for: A HOUSE PET | A CHILD | A GIFT | A MOUSER/BARN CAT | A COMPANION
FOR ANOTHER PET | OTHER_________________________________________________________________

4. Where will your adopted cat live? INDOORS ONLY | OUTDOORS ONLY | INDOORS AND OUT

5. We require that all cats to be adopted be spayed or neutered. Do you have any questions or reservations
about this? _________________________________________________________________________

6. Are you prepared to meet the financial responsibility of owning a pet?
(A cost of $300.00 to $500.00 per pet, per year.) YES | NO

7. Are you familiar with feline leukemia virus? YES | NO

8. Are you prepared to take your new pet for a complete veterinary exam within SEVEN days of adoption
to provide necessary treatment and vaccinations? YES | NO

9. Who is your veterinarian?_______________________________ Phone No._________________________

10. Is this pet going to be living with you? YES | NO
If not, with whom?______________________________________________________________________

11. How many people live in your household?____________________________________________________
What are the ages of any children in your household?________________________________________

12. Do all the adults in the household know you plan to adopt? YES | NO

13. Does anyone living in your household have any known allergy to animals? NO | (IF YES, to what kinds of animals?___________________________________________

14. What Adult will be responsible for the care of this cat? _________________________________________

15. Where will this cat be kept during the day?____________________________________________________ night?____________________________________ When alone?_______________________________

16. Please give 1 reference other than your veterinarian (include phone number/address). ___________________________________________________________________________________

17. Please list any pets you have lost or disposed of in the last 2 years.

18. How did you hear about RGCR?____________________________________________________________

19. Who referred you to us?__________________________________________________________________

IF YOU ARE INTERESTED IN ASSISTING US WITH OUR WORK,
PLEASE CHECK YOUR INTERESTS.
__________ FOSTER HOME __________ FUND RAISING
__________ HOUSE CHECKS __________ FERAL COLONY MONITORING

Really Great Cats Rescue, Inc.
5959 Lawton Avenue
Rock Hall, MD 21661
fax/tel: 410-639-7171