DivaPets Cat Rescue Adoption Application

Select from the list the animal you are interested in adopting	Betsy (Cat - U2504056) Bubbles (Cat - S2405148) Cosmo (Cat - S2412275) Hedwig the Owl (Cat - S2401003) Kumquat (Cat - U2504062) Leah (Cat - U1905104) Maisey Mae (Cat - S1810189) Molly (Cat - U2504055) Remi (Cat - U2412271)
If there are other kitties of interest, please list kitties' names
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Apartment Number (if applicable)
Zip Code *
Email Address * Please enter correctly as this is the main way we will contact you
Best Number for Contact * (digits only, no formatting)
Date of Birth *
How did you find out about us?	Petfinder Internet Search Family/Friend Staff/Volunteer Facebook/Twitter Other
Have you adopted from Diva Pets Rescue before? *	Yes No
Is this pet for you or someone else?	Myself Someone else
Do you own other pets at the current time? *	Yes No
If yes, please describe them including breeds and ages.
If you have pets, will they adjust to a new pet in the house?	Yes No Unsure N/A
Have you ever turned your dog or cat into a shelter? * This question refers to a pet of your own, not an animal that you found	N/A No Yes
If yes, please explain? *
Do you plan to declaw this cat, now or in the future? *	Unsure No Yes
Have you declawed a cat in the past? *	NoYes
If yes, please explain.
Please check the main reason you plan to adopt a pet:	Companion Family Pet Child's Pet Companion for another pet Other
If you answered "other" above, please explain here:
Please describe in detail the pet you are looking for.
Do you own or rent your home?	Own Rent Someone else owns the Home Someone else rents the Home
Please select your current residence type.	House Apartment Condo Townhouse Mobile Home Other
If you answered "other" above, please explain here:
If you rent, does your landlord and lease allow pets?	Yes No Unsure N/A
How long have you lived at this address?	Less than one month 1-2 months 3-6 months 6-9 months 9-12 months 1-2 years 3-5 years 6-10 years 10 + years
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Is everyone in your household aware that you are planning to adopt a pet?	Yes No N/A
Does anyone in your household have allergies to dogs/cats?	Yes No Possibly N/A
On average, how many hours per day will your pet be left alone?
How much do you think the annual medical bills will be for your pet? *	About $100 $100 - $200 $200 - $300 $300 - $500 $500 +
What would you do if the bills went over this amount? *
Will this pet be living inside, outside, or both? *	Inside Outside Both
How will you handle destructive behavior?
Do you currently have a vet? *	No Yes
Veterinarian's Name *
Veterinarian's Phone Number * (digits only, no formatting)
What arrangements will you make for the care of your pets in case of an emergency?	Leave with family/friend Boarding Pet Sitter Take with me/us Other
If you answered "other" above, please explain:
What will you do with the animal when you go on vacation?	Leave with family/friend Boarding Pet sitter Take with me/us Other
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal?
What would you do with your animal if you had to move? *	Take him / her with me Give to family or friend Return to shelter Other
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 10-20 years? *	Yes No
If no, please explain:
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. I am aware that DivaPets cannot guarantee the health and temperament of the animal. *	Yes No