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 Amber Amelia Anabelle Artemis IV Ash 4 Atlas Barbie Bernard Bo Bob Bria Brie Callie Carnelian Cassius & Rory Comet 4 (must be adopted with Cupid) Cupid (must be adopted with Comet 4) Dakota 2 (must be adopted with Penny Sue) Deonte (must be adopted with Monte) Flavio Gabby Jenny Lind Kiki IV Laddie 2 Lil Debbie Lilly III Marble II Merlin 10 (must be adopted with Phoebe X) Mia 8 Mighty Mouse 2 Missy Monte (must be adopted with Deonte) Mr. Manx Nando Nix Orla Pangur (must be adopted with Aisling) Penny Sue (must be adopted with Dakota 2) Pepper 3 Phoebe X (must be adopted with Merlin 10) Piano Pooh Bear Sapphire Sebastian 5 Speedy Gonzales Stuart Little 3 Sven Teddy Roosevelt Tip II 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*
