First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

Alt Email

Occupation*

Are you at least 18 years of age?*

If you are interested in a particular animal, please specify who:
Choose an animal: Artie Bailey Beau *FOSTER HOME NEEDED* Birdie Bonnie & Clyde *FOSTER HOME NEEDED* Cheeto Cricket *FOSTER HOME NEEDED* Emerson Forrest Gracie Huey & Louie Ivy Jan Juniper Kobe "Gentle Giant" Easygoing and sweet! Lulu *FOSTER HOME NEEDED* Martha Nacho *FOSTER HOME NEEDED* Oak Ocean Odin Opie Owl Rambler Reese & Rory Remi Roxy & Penny *Bonded Seniors* Sadie *Wonderful Family Dog!* Smokey Tera *FOSTER HOME NEEDED* Tippy Vortex *FOSTER HOME NEEDED* Yeti

If the kitten(s) you've expressed interest in are no longer available or are pending adoption, would you like to be contacted about other kitten(s) available?

What characteristics are you looking for in an animal? Any particular gender or age?*

How many adults in the home? Please list their names and relationship to you.*

If you have kids, list ages and if they have experience with animals.*

RRR prohibits the declawing of any kittens or cats. Do you agree to abide by this policy, knowing that if it is violated, RRR has the right to reclaim the animal?*

How many consecutive hours PER DAY are you away from home for work, school, etc.? *

Will the cat have free roam of your home or be restricted to certain areas?*

Will the cat be allowed to sleep in the bedroom(s) with owner(s) at night?

Will you new cat be indoors only, or have the ability to go outside?*

Does anyone in your household smoke inside the home?*

Do you own or rent your home?

How long have you lived at this address?*

Type of Dwelling

If you rent please give name, address, phone number, and email address of landlord:

Have you ever adopted an animal from Redemption Road Rescue before? *

Have you ever moved from one residence to another without taking your pet? Please explain the situation:*

Please tell us about your current cat(s), if any. List the following information for each cat you currently own: Name, breed, sex, age, whether or not the cat is spayed/neutered, and whether the cat lives indoors or outdoors*

Please tell us about your current dog(s), if any. List the following information for each dog you currently own: Name, breed, sex, age, whether or not the dog is spayed/neutered, and whether the dog lives indoors or outdoors.*

Have you ever had to give a pet up? If so, please tell us why?*

Please list any pets you have previously owned, along with the following information: Breed/species, how long the pet was owned, was it kept indoors or outdoors, was it spayed/neutered, and where the pet is now (if deceased, please list cause of death).*

Under what conditions would you not keep your new pet?*

Please list two NON-FAMILY personal references, their relationship to you, and their phone or email. *

E-Signature: I, the undersigned, attest that, to the best of my knowledge, the above information is accurate and complete at the time of signing. I understand that falsely provided information can mean that my application will be terminated.*