Maine Coon Rescue

Request to Place Application

NOTE: Please do not forget to forward a photo of your cat. It is necessary to submit a photo to verify that the cat is indeed a Maine Coon/Maine Coon Mix. Maine Coon Rescue cannot refer to a cat as “pure bred” unless it’s registered or has papers.

All fields must be filled in for MCR to process this form in a timely manner.

Contact Information
Name: *
Your Address: (Street, City State Zip) *
Phone Number: *
E-Mail Address: *
Location of Cat: (Street, City State Zip) *

Page 1 of 2

Cat Information
Cat Name: *
Purebred Maine Coon? *	Yes No
If yes, what is the name of the breeder?
Is this cat registered?	Yes No
If yes, what is the registered name of the cat?
Have you contacted the breeder of your Maine Coon? *	Yes No
If yes, what was the breeder's response?
If no, why not?
Maine Coon mix?	Yes No
If yes, what is the secondary breed?
Is this cat microchipped? *	Yes No
If yes, please list the Microchip number and Company:
Color: *
Sex: *	Male Female
Date of Birth: *
Size: *
Altered: *	Yes No
Up to date with routine shots? *	Yes No
House Trained? *	Yes No
Declawed? *	Yes No
Special Needs? *	Yes No
If yes, what are the special needs?
Home with young children? *	Yes No
Home with dogs? *	Yes No
Home with cats? *	Yes No
Description (Personality, etc): *
Reason for Placement: *

Page 2 of 2

*Required Fields

Request to Place Application

Contact Information

Cat Information