Online Matchmaker Questionnaire

[FrontPage Save Results Component]
If you are unable to adopt and take the cat home within the next few days, please wait to submit this form until you are ready and able to bring your new friend home.  It usually takes 5-7 days from submission of this form to the day you take your new kitty home.  Thank you.
Name of Animal Inquiring on
Applicant Name
Co-Applicant Name
Relationship
Have all adult household members been notified
that you are looking to adopt a cat and
are in agreement to adopt a cat at this time?
Home Email Address (I can check this account all times of the day and night)
* Please verify that your email address is
correct as all initial contact will be by email*
Other Email Address (I can only check this account during work hours)
How often do you check email?
Street address
City
State
Zip
Phone number(s) and best times to call
 
* Please note, we DO NOT not return long distance calls*
About Your New Cat: (Select all that apply)

Physical Characteristics

  
What age of cat are you looking for?
What gender of cat?
Coat length
Size
Color
Breed(s)
Other physical charactersitics

Personality Characteristics

  
Activity Level Use <Ctrl> to select more than one
We want our new cat have the following characteristics
Use <Ctrl> to select more than one
Do you want your new cat to be:
Other personality characteristcs

About Your Home and Family

  
Reason for Adopting
Use <Ctrl> to select more than one
Who will be responsible for caring for the cat?
Have you had animals before?
What kind?
What breed?
What happened to them?
How many animals do you have now?
In This Section Describe Your Current Animals
    Type Age Gender

Spayed or Neutered?

Vaccinated?

Declawed?
1st Animal Yes No N/A Yes No N/A Yes No N/A
2nd Animal Yes No N/A Yes No N/A Yes No N/A
3rd Animal Yes No N/A Yes No N/A Yes No N/A
4th Animal Yes No N/A Yes No N/A Yes No N/A

More About Your Home

 
Do you Own or Rent ? Does your landlord allow animals?
Yes No N/A
What is the name of the complex?
 
Does your home have a dog door?
How many adults live in your home?
Is anyone in your home allergic to cats? Yes No
How many children live in your home? What are their ages?
Do children visit your home? What are their ages?
Where will your cat stay during the day?
Where will your cat sleep during the day?
When you are out of town, do you plan to:
Use <Ctrl> to select more than one
If you would have to move would you:
Do you intend to declaw your new cat?  
How much are you willing to spend on medical expenses per year for your cat?
If medical expenses exceed your limit how do you plan
to get your cat the necessary medical procedures?
Do you have a Veterinarian? Yes   No
Name and Phone # of Vet
We will check references, are you OK with this? Yes No
Would you consider adopting an animal with special needs? Yes No

What are your greatest concerns in getting a new pet? Litter training, Allergies, etc.

If you are interested in a particular cat, why do you believe you are the best home for this cat?

When will you be available to adopt a cat and take it home?
i.e: today, this weekend, next month, after vacation, when house is
built in a few months, etc., or specifiy a date.
Any other comments
How did you hear about our rescue?

Thank you for taking the time to fill out this form.

By signing below, you are indicating that the information supplied by you on the Adoption Questionnaire is accurate and truthful. Falsification of information or intentional misrepresentation of information in the Matchmaker Questionnaire is an immediate and permanent disqualification. Should an adoption take place, you also agree to abide by the terms and conditions specified in the Adoption Contract.
Name Date