VS Cat Rescue logo Valley Stream  
             Cat Rescue


 

Application for Cat Adoption

Valley Stream Cat Rescue is a non-profit organization staffed entirely by volunteers. We are committed to serving the best interests of the cats in our care. Therefore, we reserve the right to select the home that best meets the needs of each cat. Thank you for considering a VSCR cat for adoption.

Prospective adopters must be at least 23 years of age.


Fields marked with * are mandatory.



First Name*
 Last Name*
City*
 State*
Home Phone*
Cell Phone*
Best time to reach you by phone:
 Email*
 
Please check one:
Do you:*
Own House
Own Condo/Co-op
Rent House
Rent Apartment

If you rent, are you permitted to
have pets?*
Yes No 		Do you live with:*
Parent Relative Other

Do you have screens on all doors and windows?*

How many people live with you?*
 
Employed at:*

 Employment Address:*
 
Your date of birth:*

Month       Day       Year

Marital status:*
Married Single Co-habitating		 Number of children and ages:
 
Why do you want a cat?*
(Check all that apply)

Companionship
For a child
As a mouser
 Does anyone in your household have allergies?*
Yes No

If allergies, describe*
 
Is the cat for*
Yourself A gift
 If gift, for whom?*

If a gift, is it a surprise?*
Yes No
 
Please list the number, types, ages, and sex of the pets currently in your home:
Cats*

Dogs*

Other*

 Any previously owned pets?

Their status:*
 
If you now have or had a cat, does (or did) your cat spend his time:*
Indoors and outdoors    Mostly outdoors    Indoors only   

Would your adopted cat spend his time:*
Indoors and outdoors    Mostly outdoors    Indoors only   
 
Veterinarian:
Name*
 Address*

Phone*
 
Have your pets been vaccinated this year?*
Yes No
Do your pets see your vet for an annual
check-up?*

 Date of last vet appointment:*
 
If you currently have a cat, has it been
tested for Feline Leukemia and AIDS?*

 Date of test*
 
Can you afford an unanticipated vet bill of $500?*
Easily    With some difficulty     Not at all
 
How many hours a day will the cat be left alone?*

Do you drive? *

Do you own a pet carrier?*
 What brand of food do you feed?*

Do you declaw?*

Do you neuter your cats?*
 
Who would care for you cat if you were unable?*

When you vacation (for more than 3 days), do you (or would you):*

Leave the cat alone with plenty of food, water and litter
Leave the cat alone with someone stopping in
Leave the cat in someone else's home
Board the cat
Take the cat with you
Don't take long vacations

If something should happen to you, have you made provisions for the future of your cats?*
 
Personal reference (other than family member):
Name*
 Phone:*
 
Cat you wish to adopt:*
Today's date:*
 
Would you consider adopting a pair?*
Yes     No     Maybe




Other useful information:


Would like to be added to our mailing list: Yes No



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