Maine Coon Adoptions - Adoption Application

A Division of

Fields marked (*) are required.

First Name(*):	Last Name(*):
Name of Spouse/Partner (if applicable)
Occupation:
Address(*):
City(*):	State(): Zip():
One phone number is required.
Home Phone#:
Work Phone#:
Cell Phone#:
Best time to call:
Email:

Personal Reference (cannot be a significant other or a family member)

Name(*):
Phone(*):
Best time to call:
Relationship(*):	-Co-worker -Friend -Other-Non-Relative

Personal Information (Confidential)

Do you: -Rent -Own -House-sit

How long have you lived in your current home? years.

If less than two years, prior address:

Address:
City:
State:	Zip:

If rent or house-sit, do you have landlord's permission to keep a cat?
-Yes -No

Landlord's Name:
Landlord's Phone #:

How long at this residence?

How many adults and children are in this home?

Children's ages:

Does anyone in your home have allergies? -Yes -No

What are the allergies?

Current/Previous Pets

Do you own other cats? -Yes -No

If yes, please list their names.

If yes, are they spayed or neutered? -Yes -No

Are they indoors only? -Yes -No

Are they up-to-date on rabies/distemper vaccines? -Yes -No

How do you feel about declawing?
   -Absolutely necessary.
   -Only if a cat is destructive.
   -Only a a last resort.
   -Completely opposed to it.

How many other cats have you owned in the last five years?

Please list the names of the cats you have owned in the last five years.

If you no longer have the previous cats, what happened to them? Be specific!

Do you have other pets? -Yes -No

Type of Pets?

How many?

How do they react to cats?

Reason for wanting a cat?

Have you ever been turned down to adopt from another rescue group? (Please note, if you have been turned down, this does not necessarily mean we would not adopt to you.) -Yes - No

If so, which rescue group and why?

Veterinary Information

Do you have a regular veterinarian? -Yes -No

Veterinarian's name:
Clinic Name:
Phone:

If you do not have a regular veterinarian, please explain why?

About the Cat You Wish to Adopt

Name of MC/Mix you are currently interested in:

Please provide the name of the MCA Representative/Case Manager who has been assisting you with with your adoption process:

Have you owned a Maine Coon before? -Yes -No

Why do you want to adopt a Maine Coon?

Desired age:

Desired sex: -Spayed Female -Neutered Male -No preference

Willing to adopt:
   -Declawed Cat.
   -Shy Cat.
   -Cat that needs regular medication.
   -None of these.

Where will the cat spend the day? (describe)

Where will the cat spend the night? (describe)

Number of hours (average) cat will spend alone?

Who will have primary responsibility for this cat's daily care?

How will you care for its coat?

Do you agree to provide regular health care by a Licensed Veterinarian? -Yes -No

Do you agree to contact MCA if you can no longer keep this cat? -Yes -No

Are you be willing to let a representative of MCA visit your home by appointment? -Yes -No

If not, why?

How did you hear about MCA? PetFinder.com Google Yahoo PetSmart Word of Mouth Other (please list)

Agreement

All of the information I have given is true and complete. This cat will reside in my home as a pet. I will provide it with quality cat food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a Licensed Veterinarian.

I understand MCA is a referral service and is not responsible for the accuracy of information received about the temperament, habits or physical condition of cats available for adoption.

I understand that it is my responsibility to see and evaluate the cat for myself before agreeing to adopt it. MCA recommends the adopter have the cat examined by a Licensed Veterinarian within seven days of the adoption date, at Adopters expense, and to immediately return the cat if the Veterinarian finds the animal has a terminal or life-threatening health problem, unless the Adopter agrees to assume all costs of treatment. MCA makes no guarantees about the health, quality, or condition of the adopted cat or kitten.

I am in full agreement with these terms of adoption. MCA is in no way liable or responsible for any damage, accident, or injury resulting from the placement of a cat into my household.

I verify the information I have provided in this application is above is true and correct, MCA members have my permission to contact the people listed above and verify my references.

Maine Coon Adoption (MCA) Policies

We do not charge for cats placed in new homes, other than to recover our expenses. The adoption donation fee is $150 for kittens up to one year old and $125 for young healthy cats, reduced or waived fee for elderly cats, which covers the costs of any vet-checking, testing, vaccinations, and treatment for each cat. Therefore, to continue our work, we ask for a donation when MCA is successful in matching you with a cat.

We reserve the right to refuse an applicant.

If your application is approved, you will be asked to provide a photocopy of your driver's license and a photograph will be taken of you at the adoption site.

This application will remain on file for 6 months.

Thank you for giving MCA the opportunity to assist you with the adoption of a MC/Mix furkid.

One of our volunteers will contact you after receiving your paperwork,if we have cats that might be a match for you.

If no cats are available, you will be placed on our waiting list and contacted by email or phone when a suitable cat becomes available.

Adopt