A Wing and a Prayer Animal Rescue Pre-Adoption Questionnaire
Name:
Phone
(Home):
Address:
(Work):
City:
(Cell):
Email Address:
Best time to reach you:
Please Check One
Do you own:
Home:
Condo/Co-op:
Do you rent a:
Home:
Apartment:
Are pets permitted?
YES
NO
Do you live with:
Parent:
Relative:
Do you have screens on all doors and windows?
YES
NO
How many people live with you?
Employed at:
Your date of birth:
Address:
Married:
Single:
Co-habiting:
Number of children and ages:
Why do you want a cat?
Companionship:
For a child:
As a mouser:
Does anyone in your household have allergies?
Yes:
No:
Describe:
Is the cat for: Yourself:
A gift(if so, for whom?)
YES
NO
Is it a surprise?
YES
NO
Please list your current and previous pets starting with those currently with you.
Name
Species/Breed
Sex
Age
Spayed/Neutered?
Pets Status
Does (or did) your cat spend his time:
Would your adopted cat spend his time:
Indoors and outdoors:
Indoors and outdoors:
Mostly outdoors:
Mostly outdoors:
Indoors only:
Indoors only:
Veterinarian:
Phone:
Address:
Have your pets been vaccinated this year?
YES
NO
Date of last vet appoinment:
Do your pets see your vet for an annual check-up?
YES
NO
Can you afford an unanticipated vet bill of $500
Easily:
With some difficulty:
Not at all:
If you curently have a cat, has it been tested for Feline Leukemia and AIDS?
YES
NO
Date of test:
How many hours a day will the cat be left alone?
Do you drive?
YES
NO
Do you own a pet carrier?
YES
NO
What brand of food do you feed?
Do you declaw?
YES
NO
Do you neuter your cats?
YES
NO
Who would care for you cat if you were unable?
When on vacation (for more than 3 days), do you (or would you):
Leave the cat alone with plenty of food, water and litter
Leave the cat alone with someone stopping in
Leave the cat in someone else's home
Board the cat
Take the cat with you
Dont take long vacations
If something should happen to you, have you made provision for the future of you cats?
Personal reference (other than family member):
Phone:
Cat you wish to adopt:
Todays date:
Would you consider adopting a pair?
Yes:
No:
Maybe:
Other useful information:
AWAP is a non-profit organization staffed entirely by volunteers. We are committed to serving the best interests of the cats in our care. Therefore, we reserve the right to select the home that best meets the needs of each cat. Thank you for considering a AWAP cat for adoption. Prospective adopters must be at least 23 years of age. Please note that adoptions fees must be paid by cash or check. We do not have the facilities to accept payments by credit/debit cards.