Adoption Application

First Name *

Middle Initial *

Last Name *

Date of Birth *

Spouse First Name

Spouse Middle Initial

Spouse Last Name

Spouse Date of Birth

Primary cat you're interested in (cats not listed in menu are no longer available for adoption) *

Why are you interested in this cat? *

Other cats you're interested in

Your Street *

City *

State *

Zip Code *

Home Telephone Number

Mobile Phone Number

Your Email Address *

Employment Status *

If employed, who is your employer?

Number of adults in home? *

Number of children in home? *

What are their ages?

Do you rent or own? *

If renting, what is your landlords name and number?

Have you had any animals in the last 5 years? *

If yes, list name, age, type (dog, cat, etc), and whether they are alive or deceased

If you've had cats, have they been indoor, outdoor, or both?

Have you ever declawed a cat? *

If yes, please explain why.

If you moved to the countryside would you let your cat outside? *

Veterinary References for pets from last 5 years (Enter name, address, phone #) *

How did you find Ten Lives?

By signing this application, I agree to the following: All statements made on this application are truthful; I have made no false statement with regard to family members in household, status of my home ownership and any other statements made on this application. If approved to meet the applied for cat, I understand and acknowledge that said cat may bite/scratch at the initial meet and greet. I agree that Ten Lives Cat Rescue and/or Ten Lives volunteers are not liable for any injury suffered at a meet and greet, as Ten Lives Cat Rescue cannot guarantee the behavior of said cat. *

Electronic Signature *