Mokolea Cattery
                                    Kitten Adoption Questionnaire
                       

 

 

Any information submitted via the Kitten Questionnaire shall not be considered 
confidential and may be shared with other reputable Havana Brown Breeders.


Important Instructions: 

 This form will only work if you use: Microsoft Outlook or Outlook Express for your email. 
     (Just complete the questionnaire and click "Submit Request" at the bottom of the page.)

**If you use any other type of email service (such as AOL, Gmail, Yahoo, Hotmail, etc.)
    you will not be able to submit the interactive form via my website.  Instead, you'll need
    to do the following.

   Email me at (diane@mokolea.com) requesting the form and I'll send it as an
   attachment.   Complete it and send back or simply provide the requested 
   information in an email and send it.


Name:       
Address:    
(City, State): 
Phone Numbers:   (Home)    (Cell)
 
Email:        
Number of people in household:
   Ages of Children:
Do you own or rent your home?
Own  Rent   If you rent, are pets allowed?
Do any members of your household have allergy problems?
Yes  No 
What interested you in the Havana Brown?
How much time would the cat spend alone during the day?
Will you be keeping the cat indoors at all times?
Yes   No 
 
What other animals have you owned?
Do you still have any of them?
What are their ages?
Have you ever had to give up or euthanize an animal?
Yes   No 
If yes, why? 
 
If you've had other pets, how often did they see a vet?
Do you have breeding experience?
Yes   No      Cattery or Kennel name:
 
Do you have show experience?
Yes   No       Breed shown:
What sex kitten do you prefer?
Reason for sex preference:
When are you looking to acquire your Havana Brown?
How did you learn about Mokolea Cattery?
 
Please tell us about yourself:
(Occupation, affiliations, hobbies, interests, etc.) (255 Characters Max)