JR’s Pups-n-Stuff - Rescue
Adoption Application – CATS/KITTENS
In order to be considered for an adoption you must: **Be 21 years of age** Have the knowledge and
consent of all adults living in your household**Have a valid ID with current address**Have landlord’s
name and telephone number (or lease)**Understand that JR’s Pups-n-Stuff must approve your
application**
Name (First, Last and MI):
Age/DOB:
Spouse/Partner Name:
Age/DOB:
Other Adult Name:
Age/DOB:
Street Address:
City:
State:
Zip:
Home Phone:
Work/Cell Phone:
Email Address:
**The legal name and date of birth is required for all adults residing in the home. If more than 3 adults live in
the home, please use comment section for additional information.
1. Is there a specific cat on the website you are interested in?
No
Yes
If yes, what is the cat’s name?
2. What type of pet are you looking for (check all that apply) ?
Male
Female
Adult
Kitten
3. Are you looking for a specific breed?
No
Yes
If Yes, what breed/color?
4. Do you want this pet for:
Companion
Protection
Breeding
Gift
Other
5. This pet will be without human companionship for about
hours per day, days per week.
6. Where will you pet be kept (check all that apply)
During the Day?
INDOORS
OUTDOORS
PEN
CRATE
BASEMENT
GARAGE
OTHER
7. During the Night?
INDOORS
OUTDOORS
PEN
CRATE
BASEMENT
GARAGE
OTHER
8. Where do you live?
HOUSE
APARTMENT
CONDO
TRAILER
OTHER
**I RENT
I OWN
LIVE W/PARENTS (please list parents name above)
Landlord’s Name:
Phone :
Does your landlord allow pets?
Yes
No
Don’t Know
Deposit Required?
No
Yes If Yes, what amount?
Monthly Rent Increase?
No
Yes If Yes, what amount?
**You must provide written authorization from your landlord in the form of a letter or a copy of your
lease.
9. Are you familiar with the local ordinances regarding cat ownership in your community?
No
Yes
10. Do you understand that by adopting a cat, you are required to comply with all local ordinances,
including licensing if applicable?
No
Yes
11. Please provide the following information about your household.
Number of Adults:
Number of Children:
Ages:
12. Is anyone in your family allergic to animals?
CATS
DOG
If yes, what is done to manage the allergies?
13. What will you do with your pets if you move in the future?
14. How much do you anticipate spending yearly to feed, vaccinate, license and provide medical care for
your pet? $
15. Do you have a limit on what you would spend for a medical emergency?
Yes
No
If yes, what is that limit? $
16. What do you consider an appropriate reason for euthanasia of a pet?
Page 1 of 2
17. Would you be willing to allow a representative from the shelter visit your home before the adoption is
completed as a part of the approval process?
Yes
No
18. Have you adopted an animal from us before?
No
Yes
If Yes, when and what was the animal’s name?
19. Do you realize a cat may live 25 years?
Yes
No
20. Adding a pet to your family is a lifetime commitment. Are you prepared to make a commitment for the
entire life of your pet?
Yes
No
21. It may take your new pet several weeks to adjust to its new home, especially if other pets or children
are involved. Are you prepared to allow this much time?
Yes
No
22. What steps are you willing to take to help your pet adjust to his/her new home?
23. What conditions would cause you to re-home your pet?
24. What do you plan to feed you cat?
25. What type(s) of pets do you own or have owned in the last 10 years? Please list ALL household pets.
If you no longer own the pet, please be specific as to what happened to the animal. If you have an
unneutered dog/cat, please explain why you have not altered the animal.
26. What type(s) of pets do you own or have owned in the last 10 years?
1. Name:
Type/Breed:
Kept Where?
Age:
Sex?
M F Neutered?
Yes
No Still own?
Yes
No
If No, what happened to the animal?
2. Name:
Type/Breed:
Kept Where?
Age:
Sex?
M F Neutered?
Yes
No Still own?
Yes
No
If No, what happened to the animal?
3. Name:
Type/Breed:
Kept Where?
Age:
Sex?
M F Neutered?
Yes
No Still own?
Yes
No
If No, what happened to the animal?
4. Name:
Type/Breed:
Kept Where?
Age:
Sex?
M F Neutered?
Yes
No Still own?
Yes
No
If No, what happened to the animal?
Still own?
Yes
No If No, what happened to the animal?
27. Who is (was) your veterinarian for the above animals? (applications can NOT be processed without
completion of this information).
Name:
Phone:
Please contact your veterinarian and ask them to release information to our representatives. Your vet
will be contacted to verify information.
If the vet records are under another name (married/maiden, etc.) please provide that name:
28. If this is your first pet, how do you plan to pick a veterinarian?
Comments or additional information you would like to provide to assist us in identifying the correct cat for you.
By signing below, I certify that the information I have given is true and that I recognize that any
misrepresentation of the facts may result in my losing privilege of adopting a pet. I authorize
investigation of all statements on this application. I understand that this application is property of the
JR’s Pups-n-Stuff.
Signature:
(Typed or electronic signature accepted.)
Date:
Applications may be mailed back to: JR’s Pups-n-Stuff c/o Jean Rhoten
4630 N. 135th St., Brookfield, WI 53005
Or completed applications may be emailed to: jrspupsnstuff@yahoo.com
Page 2 of 2