First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County

Email*

Home Phone

Cell Phone*

Alt Email

Which animal are you interested in? (Please note that cats are listed first with an asterisk, followed by dogs.)*
Choose an animal: **Barn Cat** **Undecided - Cat** **Undecided - Dog Small Breed** **Undecided - Family Dog - Adult** **Undecided - Kitten** **Undecided On Specific Animal** *Banjo *Bella (must be adopted with *Narcissa and *Narcissa) *Bo *Cinco *Clove *Coriander *Cuatro *Dab *Edyn (must be adopted with *Junie and *Junie) *Ella *Gemma *Ivey *Jenna *Located in Lexington, VA *Jolene *Junie (must be adopted with *Edyn and *Edyn) *Kasey *Maxine *Monkey *Mr Kitty & Lil Momma *Mr Mannie *Mrs Potts *Naomi *Narcissa (must be adopted with *Bella and *Bella) *Ruthie *Tigger *Uno *Wenona *Whitney *Winter Ace Beaumont Bullet Clementine Debo Edith Ember Enzo GiGi Leigh Ann Luca Mabel Mallard Marlowe Mr Houndy Phoenix Stella Thaddeus Togo *courtesy post- Not a CVRR animal*

I acknowledge that after my application is approved to adopt from CVRR, it will be forwarded to the animal's foster, who will review all applications to choose the home that is the best fit for the animal. I understand that CVRR does not adopt animals on a first-come-first-served basis, but rather by selecting the best home for each animal as chosen by the foster, since the foster knows the animal best. If I am not chosen to adopt the animal I applied for, I can transfer my application to another animal. *

What is your date of birth? *

When is the best time to contact you?

What is your place of employment and job title?*

Are you the owner of the home you live in? Please indicate whether you own or rent your home. Please note that we check public records for confirmation of ownership. If you, the applicant, are not the sole owner of your home, please provide below the name, address, and phone number of the owner/landlord so that we can verify that a pet is accepted. Failure to provide this information will automatically stall your application.*
Choose one: Rent Own

If renting, do you have your landlord's permission to have pets? Be prepared to provide a copy of the lease agreement or a written statement from the landlord.

If you are renting please provide your landlord's name AND contact information (phone number or email address).

Describe how long the pet will be unattended on a daily basis and where it will be kept during this time.*

Please list each person or family member in your household, stating for each their name, age, relationship to you, and whether they will be a primary caregiver for the pet.*

Have there been any other pets in your home or otherwise owned by you? Please provide names, ages, genders, breeds, etc. for any current pets as well as any previous pets.*

For any current or past pets: Are they spayed/neutered? If not, please tell us why. Are dogs on heartworm prevention? If not, why not? Have cats been tested for FeLV/FIV?*

Please provide the name and phone number for the veterinarian(s) who have provided care for any current and previous pets. (Please note that failing to provide both name and contact info may result in your application stalling.)*

Have you ever owned a cat?*
Choose one: Yes No

Does anyone in your home have cat allergies?*
Choose one: Yes No

What experience do you have with animals?*

Have you ever given up or rehomed a pet? If yes, please explain.*

Why are you interested in adopting a pet at this time?*

If your life circumstances change in the future (such as housing, family members, financial resources, etc.), what is your plan to continue to care for your pet(s)?*

Why are you interested in this particular pet at this time?*

For cats only: Are you planning to declaw? There is no right or wrong answer, we're just inquiring as to whether or not you plan to declaw or if you are against it :) *
Choose one: Yes No

How long do you think it will take this pet to acclimate to a new home environment? For example: 3 days, a week, a month?*

If you have other pets, what is your plan for introducing your new pet(s) to the household animals? Do you have an area that you can separate them until they get to know each other?*

Will the animal be kept inside or outside?*
Choose one: Inside Only Outside Only Inside and Outside

What traits are you looking for in a pet

What is your ideal personality in a cat? *

Are you interested in any other animals listed on our website? (Please list names of animals you are interested in)*

How did you find out about Central Virginia Regional Rescue?*

I acknowledge that CVRR may contact me by email, phone call, and/or SMS.*