First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

County

Email*

Home Phone

Cell Phone

Why are you interested in adopting a kitty at this time?*

Please list any other rescues that you have contacted in regards to adopting an animal.*

Are you prepared to deal with the emotional and/or physical “baggage” that many rescued cats have?*
Choose one: Yes No

Are there any emotional or physical problems that you would not be willing to tolerate in a kitty?*

Why do you want to rescue a Siamese or Siamese Mix, as opposed to getting one from a breeder?*

Do you have any experience with Siamese cats?*
Choose one: Yes No

Please list the pets currently living in the household (please include number and type):*

Are your current pets up to date on their vaccines?*

Are you planning to declaw your kitty?*
Choose one: Yes No

Have any/all the existing cats in the home been tested for Feline Leukemia & FIV? When? What was the result? *

Are your current pets spayed/neutered?*

How will you train the kitty to not claw furniture, stay off counters, etc?*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

Where will the animal sleep*

Where will the kitty have access to while you are home (examples: entire house/condo/apartment, everywhere except garage, etc)?*

Where will the kitty be kept when you are away from home?*

Have you ever given up a pet? If yes, please explain.*

Please provide the email addresses of at least two personal references who are not family members. We also request that you not use your past or current Veterinary Doctor as a personal reference. If you are unable to provide email addresses, please contact us at siameserescue@gmail.com after you have submitted this application. Thank you.*

Veterinarian's Name and Phone Number*

Who will be affected by this adoption? Significant Other? Children? *

If you rent, please enter your landlord's name and phone number. Also attach letter from landlord indicating pets are allowed.*

Do you own or rent your home? (If renting, attach letter from landlord indicating pets are allowed) *
Choose one: Rent Own

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

How many years at current residence?*

Who in the household will care for the pet*

How many people reside in your household*

Please list the ages of the children living in the household.*

Which animal are you interested in
Choose an animal: Opal

How did you hear about us*

I understand that the cat(s) I’ve requested on this application are not guaranteed to me, even if my application is approved. I understand that MISR reserves the right to place any particular cat into any particular home and that my approved application gives me no right to any particular cat(s). Please initial and date.*

Understanding that a Rescue Shelter houses cats from unknown backgrounds, I assume the risks of being bitten, scratched, injured, or frightened by the cats and kittens in connection with my visits to the Michigan Siamese Rescue (MISR) foster homes. MISR is not liable to me for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with my visits to MISR or their foster homes. Please initial and date.*

If you adopt a Siamese or Siamese mix from MISR, the animal may not be euthanized or abandoned/relinquished to a shelter. While MISR cannot guarantee that we will be able to take the cat back into a foster home, we will assist you in locating another home. Adopted cat(s) may be reclaimed at any time by MISR if it is learned that the terms of your Contract are not met or if there is any falsification of information on any documents you have submitted. MISR will be more than happy to provide you with advice on any problem you have with the pet to the best of our capabilities. If the Siamese or Siamese mix adopted is too young to be spayed or neutered at the time of adoption, by signing this Application, you agree to have the pet spayed or neutered at the appropriate age, providing MISR with confirmation of the sterilization, in return for which a spay/neuter deposit, paid at time of adoption, will be refunded. You agree to care for the adopted cat according to all state and city laws, including licensing requirements. You agree to maintain proper vaccination of the adopted cat for rabies and distemper. You understand that no refunds are given on adoption fees should the adoption not be successful, although MISR will assist you in the selection of another cat of your choice. I certify that the information entered on this applicant is true. Please sign and date.*

There is a $10 non-refundable application fee (not applicable to the adoption donation) required before this application will be processed. If mailing the application please include a check or money order for the fee. If faxing or emailing this application you may mail the fee separately or pay to CreditCard@Siamese-Rescue.com by using www.PayPal.com. It is the responsibility of the potential Adopter to be aware of any and all policies of using PayPal to pay for the application fee and the adoption fees. Please refer to the PayPal policies page at https://www.paypal.com/us/webapps/mpp/ua/upcoming-policies-full . If this form is filled out online or as an emailed document it will be considered void if there have been any changes to the language of this form. If received by email the applicant waives their actual signature and accepts all contract language in this application. Please sign and date*

I understand that even if my particular home situation may be right for a particular cat, that other applicants with a higher priority (based on date completed application is received) than mine may have preferential rights. Please initial and date.*

I understand that the recurring cost of maintaining a cat can exceed $100 per year of vet bills, vaccinations and routine tests. I agree to perform all routine health maintenance annually. Please initial and date*

I understand that by applying to Michigan Siamese Rescue (MISR) to adopt a cat, MISR requires a veterinary reference to ensure appropriate placement. I hereby give permission for MISR to contact my Veterinary Doctor in regards to care that has been provided to any animal that I have brought to their clinic. I agree to hold MISR harmless and free of any liability regarding any information that might be given to MISR. Please provide an email address that we can use to contact to your Veterinary Doctor to fill out our online reference form.*