Mending Hearts Rescue
mendingheartsrescue@yahoo.com
Home
About/Donations
Contact
Adoption
Cat Application
Dog Application
Volunteer
Volunteer Application
Foster Application
Events
Partners/Sponsors
Cat Adoption Application
Requirements
Must be 21 years or older
Must have the consent of all adults in the home
If renting have written consent from landlord to have a dog at the address listed
Consent to a home visit
*
Indicates required field
Cat Name
*
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Are you
*
Employed
Unemployed
Retired
Disabled
Employer's Name
*
Employer's Number
*
Type of home
*
House
Apartment
Condo
Other
Do you?
*
Own
Rent
Live with parents
Live with roomates
Other
Landlord Name
*
Landlord Number
*
How long at address?
*
Previous address if less then 2 yrs
*
Are you familiar with Pet Laws in your area?
*
Yes
No
Are you willing to let an MHR rep visit your home?
*
Yes
No
Please list all members of your home
Name
*
Relationship
*
Age
*
Role in care
*
Name
*
Relationship
*
Age
*
Role in Care
*
Name
*
Relationship
*
Age
*
Role in Care
*
Allergies to pets?
*
Yes
No
Is this your 1st cat
*
Yes
No
Are you familiar with a cat's needs?
*
Yes
No
Why are you interested in adopting?
*
Companionship
To Breed
Gift
Do you plan on declawing?
*
Yes
No
Ever taken a pet to a shelter?
*
Yes
No
If yes, why?
*
Cats can be costly over the years, vaccines, license, food. Are you prepared to care for this cat for it's entire life>
*
Yes
No
Unsure
How often do you scoop the litter box?
*
Past pets
Name
*
Type
*
Age
*
Male/Female
*
Fixed & Up to date on shots?
*
Still Own?
*
Indoor or Outdoor
*
If no, why?
*
Name
*
Type
*
Age
*
Male/Female
*
Fixed & Up to date on shots
*
Still Own?
*
Indoor or Outdoor
*
If no, why?
*
Name
*
Age
*
Type
*
Male or Female
*
Fixed & Up to date on shots
*
Indoor or Outdoor
*
Still Own?
*
If no why?
*
Who cares for your pets when you travel?
*
Where will the cat be kept during the day?
*
Where will the cat be kept at night?
*
How long will the cat be alone each day?
*
Important Personality traits?
*
New cat's sometimes take months to adjust to a new home. Are you willing to allow time for adjustment?
*
Yes
No
Unsure
Do you understand if you can no longer keep this cat you must return them to MHR?
*
Yes
No
If no why?
*
How did you hear about us?
*
References
Veterinarian Name
*
Veterinarian Phone Number
*
Do we have your permission to contact?
*
Yes
No
Personal Referances
Name
*
Phone Number
*
Years Known
*
Name
*
Number
*
Years Known
*
By submitting this application, I certify the above information is true and correct. I understand any misrepresentation of the above may result in refusal of application. I understand that adoptions are at the discretion of the MHR representative and completion of this form does not guarantee adoption.
Electronic Signature
*
Date
*
Submit