First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
Email*
Home Phone
Work Phone x
Cell Phone
Alt Email
Text/Pager Email
If you have previously applied to adopt through us within 1 year of today's date, please do not complete another application. Contact ASR directly with any new information (i.e. change in reference, vet, cat/kitten name).
I have previously adopted from ASR.
If yes, identify year.
Which animal are you interested in, if any? (Only 1 application is needed for all the cats or kittens you are expressing interested in). Choose an animal: Addison Agnes II Aisling (must be adopted with Pangur) Alfreda Alonzo Alton aka Snow Amélie Anabelle Baby S Benjen Betty Cooper (must be adopted with Veronica Lodge) Bob Bria Brienne (must be adopted with Shireen) Callie Cassius & Rory Chewbacca (must be adopted with Han Solo 2) Coco VIII Comet 4 (must be adopted with Cupid) Cotton Cupid (must be adopted with Comet 4) Cutie Pie Diamond Dolly IV Ember 3 Emilia Flan Fluffball Gabby Han Solo 2 (must be adopted with Chewbacca) Jake Jenny Lind Joe Jo Kiki IV Laddie 2 Lilly III Lily 7 Machi Mama Brie Maybe 2 Mishka Missy Natasha 3 Oscar 3 Pangur (must be adopted with Aisling) Piano Pooh Bear Rogo Rogue Sapphire Sebastian 5 Shireen (must be adopted with Brienne) Sing Song Starburst Sven Veronica Lodge (must be adopted with Betty Cooper) Xena Yeti Yoli Zira II
Which other cats are you interested in, if any?
Why are you interested in adopting a Siamese cat at this time?*
List the names and ages of your current pets*
List pets you have owned in the past*
What happened to the pets you have owned in the past?*
Are your current pets up to date with their vaccinations?* Choose one: Yes No Not Applicable
Do your current cats test negative for FeLV and FIV? Do your current dogs test negative for heartworm?* Choose one: Yes No Not Applicable
Are your current pets spayed or neutered* Choose one: Yes No Not Applicable
If not spayed or neutered, why not? (must answer if pets are NOT spayed or neutered)
What traits are you looking for in a cat
Will your cat be kept inside or outside?* Choose one: Inside Only Outside Only Inside and Outside
Are you planning to de-claw?
How many people reside in your household? List names and ages*
Who in the household will care for your cat*
How much time will your cat spend alone during the day?*
Where will your cat sleep*
Where will your cat be kept when you are at home*
Where will your cat be kept when you are not home*
Have you ever given up a pet? If yes, please explain*
List at least two references (who are NOT family members) with name, phone number or email (Email Preferred). *
Veterinary Clinic Name, Phone and Fax Number (If you do not have a pet or have not had a pet in the last 3 years, a third reference name is required). *
In what type of home do you live* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you own or rent your home* Choose one: Rent Own
If you rent, have you received the approval of your landlord to have an animal Choose one: Yes No
If you rent, please enter your landlord's name and phone number
How did you hear about us*
Have you applied with any other rescue
I certify that the information entered on this applicant is true. I understand and acknowledge that both the veterinary and personal references listed will be contacted as part of the application process and I give Austin Siamese Rescue permission to do so. Enter your name and date*
