ADOPTION APPLICATION
305 Ross Drive, Mill Valley, CA
A non-profit 501 [c] (3) Tax exempt organization

v    We have beautiful adult Persian and Himalayan cats for adoption to very loving people who provide:
          Ø      INDOOR homes only
          Ø      No declawing or tendonectomy(some cats are already declawed)
          Ø      Proper grooming (daily) for the long Persian and Himalayan coat  
          Ø      Proper veterinary care, food, water and attention
v    The cats have all tested negative on their Feline Leukemia tests. They are spayed or neutered and vaccinated
         against upper respiratory illness.
v    We ask for a $175.00 adoption fee.
v    WE DO NOT SHIP CATS.

Name:_____________________________________________ Home Phone.___________________________
Spouse's Name:_____________________________________ Work Phone:____________________________
Address:___________________________________________ City/State/Zip:_________________________
Employer:__________________________________________ Work Phone:____________________________
Cellular Phone: _________________________Email:_____________________________________________
California Driver's License No _______________________________________________________________

In case we need to reach you for follow-up on the adoption please provide an additional contact of the name and
phone of a friend or relative who does not live with you:
Name:___________________________________________________________________________________
Phone:___________________________________________________________________________________

Please List 2 References:

Name: ______________________________________________ Phone:_____________________
Address:________________________________________________________________________
Name: ______________________________________________ Phone:_____________________
Address:________________________________________________________________________

Veterinarian's Name, Address & Phone number:
_________________________________________________________________________________________
_________________________________________________________________________________________

YOUR HOUSING
____Own House ____Rent House ____ Own Condo____Rent Apt____Mobile Home
If you rent, what is your landlord's name?______________________________________________________
Are cats allowed?_____ Yes ,____ No ,____ Unsure. Landlord's Phone:_____________________________
If you rent, is a pet deposit required?__________ How much?__________ Has it already been paid?_________
How long have you lived at your present address?_______________________________________________
Are you planning to move within the next six months?________________________
How long have you been looking for a new cat?_________________________________________________
How many adults in the household?________ How many children?________ Ages___________________
Who will be responsible for the cat's care?______________________________________________________
Does anyone in the household have animal allergies?_____________________________________________
Is there anyone in the household who does NOT want a cat? __________

PET HISTORY
Have you ever had a cat before? Yes____ No____
If yes, what happened to it?__________________________________________________________________
How long did you have it?____________ Was it spayed or neutered?________________________________

CURRENT PETS
What pets do you currently have in your home? Include small caged pets and barnyard animals.

Have you ever taken an animal to a shelter or a pound?___________________________________________
If yes, what were the circumstances? __________________________________________________________
_________________________________________________________________________________________

BREED KNOWLEDGE
Have you ever owned a Persian or Himalayan Cat? _________________
If no, are you willing or have you already done reading about the breed to familiarize yourself with the special
needs of Persian cats?  Yes______ No__________
What qualities do you like about the Persians & Himalayans?__________________________________
What qualities do you like the least about Persians & Himalayans?______________________________
How do you plan to handle the grooming needs of your Persian or Himalayan?
_____________________________________________________________________________________

CAT CARE
Do you believe in spaying or neutering your pets?___________ Why or why not?______________________
How many hours per day will the cat be left alone?______________________________________________
Where will the cat be kept during the day when you are gone? _____________________________________
Where will the cat be kept at night?___________________________________________________________
Are you familiar with the way to train a cat to use a scratching post? ________________________________
What will you do if the cat scratches the furniture or the carpet? ____________________________________
_________________________________________________________________________________________
What kind of food are you planning to feed the cat?______________________________________________
Are you aware that you need to properly introduce a cat or kitten to its litter box? _____________________
Do you know how to gradually introduce new pets to old? ________________________________________
Are you familiar with life-threatening F.U.S. (Feline Urologic Syndrome) Symptoms?___________________
If you have any difficulty with any of the cat's behavior whom will you call for advice?
_______________________________________________________________________
If you must give up the cat what would you do?_________________________________________________

Which, if any, of the following reasons would cause you to give up your cat? Please keep in mind that we
have had cats  given up for each of these reasons.
The cat defecates or urinates in places other than the litter box.
Allergies.                     The cat is old.                     The cat smells
The cat doesn’t like our new puppy/kitten.          Don’t want to wash the cat’s face everyday.
Too expensive to care for.                                      Health problems with the cat.
The cat scratches children/grandchildren.          Cat scratches the furniture or carpets.
If your pet becomes sick or injured how much money do you feel is appropriate to spend on veterinary care?
 $________  Explain: ___________________________________________________________________________
_____________________________________________________________________________________________
What arrangements have you made for your pets in your will? _____________________________________________________________________________________________

BE SURE YOU KNOW YOU CAN ALWAYS RETURN THE CAT TO
Persian & Himalayan Cat Rescue!!!

I certify that all the information in this application is true and I understand that false information may void the application. If approved, I understand that this application will become part of my adoption agreement, which is a binding document.

SIGNATURE_____________________________________________ DATE___________________________

Please understand that the Persian & Himalayan Cat Rescue (PHCR)
 reserves the right to deny any adoption application for any reason.