A Wing and a Prayer Animal Rescue Pre-Adoption Questionnaire
Name:
**Your name is mandatory
Phone
(Home):
**One contact number is mandatory
Address:
**Address is mandatory
(Work):
**One contact number is mandatory
City:
**City is mandatory
(Cell):
**One contact number is mandatory
Email Address:
**Email is mandatory
Best time to reach you:
**Time to reach is mandatory
Please Check One
Do you own:
Home:
**One choice is mandatory
Condo/Co-op:
**One choice is mandatory
Do you rent a:
Home:
**One choice is mandatory
Apartment:
**One choice is mandatory
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:
**DOB is mandatory
Address:
Married:
Single:
Co-habiting:
Number of children and ages:
Why do you want a cat?
Companionship:
**One field is mandatory
For a child:
**One field is mandatory
As a mouser:
**One field is mandatory
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:
**One field is mandatory
Mostly outdoors:
Mostly outdoors:
**One field is mandatory
Indoors only:
Indoors only:
**One field is mandatory
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:
**One field is mandatory
With some difficulty:
**One field is mandatory
Not at all:
**One field is mandatory
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?
**This field is mandatory
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
**One field is mandatory
Leave the cat alone with someone stopping in
**One field is mandatory
Leave the cat in someone else's home
**One field is mandatory
Board the cat
**One field is mandatory
Take the cat with you
**One field is mandatory
Don't take long vacations
**One field is mandatory
If something should happen to you, have you made provision for the future of you cats?
Personal refernce (other than family member):
**Personal Reference is mandatory
Phone:
**Refernce Phone # is mandatory
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.