Blank Adoption Form – Crystal Creek Rescue

Cat's Name*

Cat's Date of Birth*

Cat's Sex*

Adoption Fee*

Your Information

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Age of all household members*

List any animals you current own, their age, and whether they are spayed/neutered or not.*

Are all of your animals current on their vaccinations?*

What is the name of your veterinarian?*

What is the phone number of your veterinarian?*

List the animals you previous owned in the last 2 years and where are they now?*

Do you own or rent?*

Type of dwelling*

If renting, please list landlord's name and phone number

Where will the pet be during the day?*

How many hours will your pet be alone during a typical day?*

Please enter a number from 0 to 24.

Why do you want to adopt this pet? As a companion for...*

Do you plan to declaw your cat/kitten?*

Do you plan to keep this cat/kitten indoors or outdoors?*

Please read and check each box below.*

We ask for an adoption fee to help cover the costs of the cats/kittens veterinarian visits including spay/neuter services, medications & rabies, chipping, food and care. Some breeds are higher fees. These donations allow us to operate.
I understand that this application does NOT reserve this animal. I understand that the adoption agent has the right to deny or postpone any adoption. All information provided is true to the best of my knowledge.

Signature*

Date*