First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

Cat preference

Birth Date *

Residence*
Choose one: House Duplex Apartment Condo Mobile Home

Occupancy*
Choose one: I own I rent* I live with my parent/guardian

*If you rent, what is the name & number is landlord/condo manager?

Other Residents & Ages of Children (if applicable)

Does anyone in your home have allergies?

If yes, who and what type of allergy?

Who is this pet for?*
Choose one: Myself My Family Relative Friend

Where will cat be kept?*
Choose one: Indoors Outdoors Both Indoors & Outdoors (explain below)

Explain Indoors & Outdoors:

Have you ever had a companion animal before?*
Choose one: Yes No

Please list current & past pets here (please list current and past pets you have owned in the past ten years, indicating breed, gender, spayed, neutered, pet's age, if you still have them and if not, why not?)*

Do you need information or assistance with proper introduction techniques? (Every cat is different and will respond differently to new environments and new family members, which require proper introduction methods in order to ensure a happy & healthy transition.)*
Choose one: Yes, I would like information No, I am already familiar with introduction techniques

Veterinarian Name*

Vet Clinic Name*

Vet Phone Number*

Vet Email*

Will you declaw the cat you would like to adopt?*
Choose one: Yes No Front Paws Only

As your new cat transitions to your routine, it may take a month (or more) to adjust. Are you willing to devote time to the transition process and work with your newly adopted cat?*
Choose one: Yes No

*MUST READ* I acknowledge that I have read and fully understand the contract presented below and by entering my full name and pressing "Submit", I represent and warrant that I am the individual identified and I understand and agree to be bound by the legal contract set forth below.

To meet a pet, a potential adopter should fill out the adoption application, meet the pet and have a compatibility interview. We give preference to adopters in the immediate area of Pittsburgh. We do not use a first-come, first-serve process and we decide who is going to be the best match for each pet. The process is intended to ensure a best-fit, long-term successful adoption for both the family and pet. * If you rent, provide a copy of your lease and addendum allowing pets to KQCR * By signing this adoption application, you agree to provide vaccinations, health check-ups and any additional veterinary care, by a qualified veterinarian, on a yearly basis. * Your adoption fee is a donation to KQCR and is nonrefundable. * When adopting a cat or kitten, you must bring a secure cat carrier along when picking up your new pet. By signing this form, I/we acknowledge that the information on this form is true and correct. I/we agree to all provisions indicated on this form. I/we understand that any misrepresentation of fact may result in Kitty Queen Cat Rescue, Inc. refusing adoption privileges to me/us. If my/our request for adoption is approved and later Kitty Queen Cat Rescue, Inc. discovers the above information is not true or correct, this application becomes null and void. Because of my breach of contract, Kitty Queen Cat Rescue, Inc. reserves the right to remove the adopted pet from my home, and I will be held responsible for any associated legal costs incurred as part of said reclamation process. In order to ensure the best homes for our rescued pets, we reserve the right to deny any adoption application.