First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

Date of Birth*

Have you been convicted of any felonies in the past 5 yrs? By submitting this application you agree to a basic criminal history check and calls to your specified references.*

If yes, for what:

In what type of home do you live?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

If you rent, please enter your landlord's name and phone number

Length of time at present home address: *

Do you have any future moving plans:

Are you willing to provide outdoor cats with food and water daily?*

Are you willing and able to keep the outdoor cats contained in a secure enclosure (cage, barn, shed, etc.) initially for 3-4 weeks before releasing them?*

Have you had outdoor cats in the past?*

If yes, how many and how long did you have them?

Are you willing to let a representative of Ruff Start Rescue visit your home virtually by appointment:

How did you hear about Ruff Start Rescue?*

Please list the following information for any additional adults living in the household. First Name, Last Name (Maiden Name), Date of Birth, and Cell Phone #.*

Is your site/home located in a high traffic area?*
Choose one: Yes No

If yes, please describe how close the cats will be to the traffic areas.

Do predators such as coyotes have access to your site?*
Choose one: Yes No

If yes, explain what type of predators you have and what measures you would be willing to take, if any, to keep the cats safe.

What type of shelter can you provide outdoor cats from weather and predators? *

Is there a heat source? Other animals or insulation?*

By signing this application, you (the applicant) agree that if/when we bring the animal to any meet-and-greet/home visit, Ruff Start Rescue is not liable for any damage or injury, and you (the applicant) assume all risks (initial if you agree).*

I certify that the information entered on this application is true. Enter your name and date *