First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Cell Phone

Your Age*

Employer*

Name and age of others living in the household: *

Do you... Own? Rent? Live with Relatives?*
Choose one: Rent Own Live with Relatives

Apartment number (if applicable)

If you rent or live with relatives, please list the name and phone number of the owner/landlord

How long have you been at this address?*

Will you allow a volunteer to visit your home?*

Is anyone in the home allergic to cats?*

If yes, how will you manage the allergy with a cat in your home?

Please list all of your current pets. Include name, type of pet, age, and if they are spayed/neutered. *

Please list any previous pets. Include name, type of pet, age, and what happened to them. *

Have you ever surrendered or rehomed a pet?*

If yes, what where the circumstances?

Current veterinarian name and phone number, and name account is under.*

Previous/Secondary veterinarian name and phone number

You must call your veterinarian's office and give permission to release your pet's records to FFRV. Do you give permission to obtain your current and past pet's medical records?*

How much do you estimate the ANNUAL cost be to care for this pet?*

Which cat are you interested in, and why are you interested in this particular cat?*

What arrangements will be made for your pet when you go on vacation or travel?*

What arrangements will you make to ensure care of your pet in the event of YOUR death or serious illness?*

If your life circumstances change (marriage, divorce, new baby, move, etc.), what will you do with this pet?*

Do you plan on declawing this cat?*

What will you do if this cat(s) scratches furniture, rugs, or people?*

What circumstances do you feel justify surrendering or rehoming a pet?*

Where will this pet spend the majority of time?*

Please provide names and contact information of THREE (3) personal references, NOT living with you. At least 2 must be UNrelated to you. Please indicate if phone numbers are mobile or landline.*