First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone*
Alt Email
Text/Pager Email
Please complete this form to apply to adopt one of our cats:
Please complete all relevant fields. Those marked with an asterisk are required before you can submit the form. We will contact you as soon as possible after receiving your Adoption Application. Please be patient, but if you have not heard from someone within 48 hours, please send an email to JBsRescue@gmail.com
Name of cat you would like to adopt?* Choose an animal: Bella Mia Boyd Buttercup Charlie Dusty French Fry Lacey Lalo Marble Moon Patches Peaches Phoenix Potato Punkin Spunky Sweet Pea Tortellini
Your Age?* Choose one: Under 21 21-25 26-35 36-45 46-55 56-65 66-75 76-80 Over 80
Will this be your first experience with a pet?* Choose one: Yes No
Have you ever adopted a pet before?* Choose one: Yes No
If so, Name of Shelter or Rescue Organization
Have any of your pets (past or present) been diagnosed with an infectious disease, such as FIV, FeLV, and/or FIP* Choose one: Yes No
Currently, how many pets are living with you?*
Please list all pets living with you currently (Name, Dog/Cat, Breed, Age, M/F, Spayed/Neutered, Kept Where?*
Name and telephone number of your current Veterinarian?*
Please list all pets (dogs and/or cats no longer living with you) you have owned in the past 5 years: Name, Dog/Cat, Breed, Age, M/F, Spayed/Neutered, Kept Where, and Reason No Longer with You?*
Name and telephone number of veterinarian who treated your previous pets?*
What type of residence?* Choose one: House Duplex Condominium Apartment Mobile Home Other
Do you Own or Rent your home?* Choose one: Own Rent
Do you plan to move soon?* Choose one: Yes No
How long have you lived at your current address?*
How many times a year do you travel?*
Where would your pet stay when you go out of town?*
How many people live in your household?*
List ages of any children living in household*
Is anyone in household allergic to animals?* Choose one: Yes No
Do you have the consent of all adults in this household to adopt this pet?* Choose one: Yes No
Who will be primarily responsible for care of the pet?*
Where will this animal be kept during the day?* Choose one: Garage Crate Outside Mostly Outside Inside Mostly Inside
Is anyone home during the daytime?* Choose one: Yes No
How many hours at a time will this pet spend alone?*
Where will this pet be kept at night?* Choose one: Garage Crate Outside Mostly Outside Inside Mostly Inside
Are you familiar with the leash, licensing and HOA rules in your community?* Choose one: Yes No
Do you have a dog door installed in your house?* Choose one: Yes No
Will you declaw this cat?* Choose one: Yes No
Are you aware of the alternatives to declawing?* Choose one: Yes No
Have you litter box trained a cat before?* Choose one: Yes No
Where will you keep the litter box?*
No cat is perfect. Please check ALL behaviors you are unwilling/unable to work through.
Comments - Please add any additional information here.
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