Online Application

Online Adoption Form
Feel free to be detailed in your answers!
(All long-distance calls to KCSR regarding available meezers may be returned as a "collect call" to reduce costs)


First Name:
Last Name:

State: Zip Code:

Daytime Phone:
Evening Phone:

Date of Birth:
Your Email Address:

How did you hear about us?

Are all the members of your family in agreement concerning this adoption?
Yes No
How many children are in the family and what are their ages:

Do you rent or own your home?
Rent Own
If you rent, please provide contact information for your landlord:

Other pets in the home (names and breeds):

What are the maximum hours each day your pets are left alone?

List other cats and dogs you have owned in the last five years:

If any of the above listed pets are deceased, at what age did they die?

Are your pets current on all vaccinations?
Yes No
If not, please explain why:

If you own cats, have they been tested for BOTH Feline Leukemia and FIV?
Yes No
Have they ever tested positive for either Feline Leukemia or FIV?
Yes No
Are your pets spayed or neutered?
Yes No
If they are not, can you please explain?

Would this cat be indoor, outdoor, or both?
Indoor Outdoor Both

In your opinion, what is the most effective way to teach a cat to use a scratching post?

In your opinion, what is the most effective way to teach a cat to not jump onto counters?

If you are forced to move and would not be allowed to take your pet, what would you do?

Have you ever given up an animal before?
Yes No
If yes, please describe the circumstances:

What age, sex, and color of kitten/cat are you looking for?

Is there a particular cat/kitten listed that you are interested in?

Why do you want to rescue a cat/kitten as opposed to getting one from a breeder?

Please provide us with two references not related to you (name, telephone number, and email address):
Reference 1:
Reference 2:
Please list your veterinarian's name, address, and phone number for reference:

If you reside outside of the Greater Kansas City Metro, and if your application is approved, by what means do you plan to transport your new pet to your home?

The following three items are for Siamese inquiries only:

Do you have any experience with siamese cats?
Yes No
If yes, please elaborate:

What qualities are you looking for in a Siamese?

Please electronically sign your application below by entering your name and today's date.

Your Name:


Please enter the security code shown above to continue with your application. Please note that the code is case-sensitive.

We reserve the right to refuse adoption for any reason