Persian Rescue of Virginia Adoption Application

The mission of this volunteer non-profit group is two-fold:

1. We place healthy, sterilized cats as pets into loving permanent homes, where they will be considered treasured members of the family for the rest of their lives.
2. We teach and coach new guardians how to properly care for their pet’s emotional and physical well-being. In doing so, we facilitate loving, mutually rewarding relationships between pets and their guardians.

Our adoption fee depends on medical needs of the cat you adopt. Every cat will be spayed/neutered, have tested negative for FIV/FeLV, be current on rabies and distemper vaccines, and may have received other interventions (as necessary). We will discuss with you the cat’s history, health, and the medical services s/he received while in our care.

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Adoption Application

To ensure that this adoption is in the best interest of you and the cat you select, we ask that you answer the following questions on both sides of this application. Please print your replies, write clearly and in capital/block letters.

Name of cat(s) you are interested in:

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Today’s date (date of application): _______________ Earliest adoption date: ______________

YOUR NAME(S):____________________________________________________ Fax(_____)____________________

YOUR ADDRESS:
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CITY/STATE/ZIP: ________________________________

TELEPHONE: Home (____)________________ Work (____)__________________ Cell (____)_____________________

E-MAIL (print in capital/block letters): __________________________________________________________________

How long have you lived at your present address? _____________ Do you own? ___ Rent? ___ Other? _______________

Is this residence a house? ___ Townhouse? ___ Apartment/condo? ___ Mobile home? ___ Co-op? ___ Other? __________

If applicable, do your Homeowners Association rules and bylaws allow you to have a cat? ____ How many cats? ______

If you do not own, please give phone number of the landlord or rental agent so we may verify that you are permitted a pet:

Name: _____________________________________________

Street Address:___________________________

City, State, Zip: _____________________________________

Telephone: (____)_________________________

Name of your employer: _____________________________________

Telephone: (____)_________________________

Number of people in the household: Adults working: ___ Adults at home: ____ Seniors working: ____ Seniors retired: ____

Names and Ages of Teens/Children/Babies: ______________________________________________________________

Is someone home during the day? ___________ How long will the cat be alone per day? ___________________________

Where will the cat be kept during the day? _______________________ At night? ________________________________

While you are not at home? ____________________________ When you travel? _________________________

Who in your family will be responsible for the pet’s daily care? ______________________________________________

Do you have a veterinarian? _____ Please, provide his/her telephone number: (____)____________________

Name of Doctor: _________________________

Name of Clinic: ______________________________________

Clinic Address: __________________________

City, State, Zip: ______________________________________

A cat may live 20 years or more. Do you agree that pet guardianship is a commitment for the cat’s entire lifetime? _____

Please tell us why you want to become this cat’s guardian? __________________________________________________
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What method(s) of training or correction do you use if the cat misbehaves? _____________________________________
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What kind of cat behaviors do you feel unable to accept? ____________________________________________________
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What would cause you to return the cat to us? _____________________________________________________________
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Should you be unable to keep the cat, will you return the cat to us? ______

Do you know that the costs of veterinarians and medications can be several hundred dollars per visit per pet? _____ Given the costs of veterinarians, clinics, and medications, how much do you think a routine visit to the vet will cost?__________ How often will you take your cat for routine vet visits? ______________What is the maximum you are willing and able to spend on vet bills per year? ___________How much do you think it will cost to feed, purchase supplies for, and care for this cat each year?__________What is your annual household income (proof of income may be required)?____________
Will you allow the cat out-of-doors? _________ Will you keep him/her indoors only? _____________
Did you have any of your previous cats declawed or have their tendons cut? __________ Do you plan to declaw this cat
or have his/her tendons cut? ____ If so, please tell us why you would have such a procedure done: _______________
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What provisions will you make to allow your cat to scratch, jump, play, explore, and hide in play?_________________
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Are there other pets in your home? _____ What kind and how many? __________________________________________

If you are the guardian of a dog or dogs, have they been exposed to cats? ____

How did they behave/react to cats? ___________________________________________________________________

Please list all of the companion animals that you have been guardian to in the last five years.

• Pet’s Name
• Type/Breed
• Age
• How acquired?
• Sterilized?
• How long in your care?

• Where is he/she now?

Have you or any member of your household been convicted of cruelty to animals? _____

Please take a minute to review your answers. Use this area for any comments or explanations you want to add. If necessary, add additional pages to this explanation. We encourage you to write down anything you might consider relevant for this application. Then, please fax the application to the number on the top left side of the front page.

Thanks.

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Reference __________________________________________________________________________________________

(Name / phone number)

Reference__________________________________________________________________________________________

(Name / phone number)

I/We certify that the information provided is true. I/We understand that giving false information will void this adoption.

___________________________________ _______________________________

(Applicant’s Signature / ID Type and Number)

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(Applicant’s Signature / ID Type and Number)