First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

What is the best time call you? Keep in mind our Volunteers call from their own phones, so you may not recognize the caller ID.

Please select the cat you are interested in adopting below. If you have not yet decided, just leave this blank.
Choose an animal: Brianna Bug (FIV+) Cranberry Sauce Djanga Koga Lehem Pepper Shaun Cassidy Tassa

If you specified a particular cat, where did you see the cat posted?
Choose one: For the Love of Cats Rescue and Adoption website Already a LOCRA adopter Friend/Relative/Coworker PetFinder Adopt a Pet Facebook NextDoor Petsmart Other

If you did not specify a particular cat, how did you hear about our Rescue?
Choose one: For the Love of Cats Rescue and Adoption website Already a LOCRA adopter Friend/Relative/Coworker PetFinder Adopt a Pet Facebook NextDoor Petsmart Other

Please name any second party in the adoption.

What is your age? *

Do you own or rent your home (choose one)?*
Choose one: Own Rent

If you Rent, please provide your Landlord's Name and Phone number.

Past Pets

Please let us know about current and previous animals you have owned in the past 7 years using the next few questions.  (**If you have not had animals in the last 7 years please put: not applicable).  Please include the following information in the box below for EACH animal:

Pet #1 NAME, pet TYPE, Pet AGE, If they had been STERILIZED?, If they had been CURRENT ON SHOTS? INSIDE or OUTSIDE animal? WHAT HAPPENED to the animal? *

Pet #2 NAME, pet TYPE, Pet AGE, If they had been STERILIZED?, If they had been CURRENT ON SHOTS? INSIDE or OUTSIDE animal? WHAT HAPPENED to the animal?

Pet #3 NAME, pet TYPE, Pet AGE, If they had been STERILIZED?, If they had been CURRENT ON SHOTS? INSIDE or OUTSIDE animal? WHAT HAPPENED to the animal?

Pet #4 NAME, pet TYPE, Pet AGE, If they had been STERILIZED?, If they had been CURRENT ON SHOTS? INSIDE or OUTSIDE animal? WHAT HAPPENED to the animal?

Please use this space to identify any other animals you have owned, including the name, type, age, sterilized?, current on shots?, inside or outside?, and what happened to the animal?

Please list any other animals in the home not owned by the primary applicant.

Do you have a veterinarian? *
Choose one: No Yes

If you answered yes, please provide the NAME and PHONE number for your veterinarian. We will be contacting your veterinarian; PLEASE BE SURE to give your vet's office permission to speak to our staff about you and your pet(s).

Please identify who you are adopting this cat for? Select all that apply (to select multiple options, press the "Ctrl" key while selecting multiple items).
Choose all that apply: Myself My child(ren) My family A friend A relative A companion for another pet

Do you prefer a male or female? *
Choose one: Male Female No preference

How many hours a day will your cat be alone during the day?*

Please identify what hair length you prefer:*
Choose one: Long hair Medium hair Short hair No preference

Please identify any other animals your cat must get along with. Please select all that apply (to select multiple options, press the "Ctrl" key while selecting multiple items).
Choose all that apply: Cat(s) Dog(s) Other animal type Not applicable, no other animals

Do you plan on declawing?*
Choose one: Front Paws Back Paws All Paws Not Declawing

Please let us know what your ideal cat would be like in the space below: *

Please identify how many children live in the home with you as well as their ages.

Please provide the total number of other adults living in your home.

What would you select the noise level of your home?*
Choose one: Low Medium High

Please provide a digital signature in the text box by typing your full NAME and DATE below.*