Important Instructions: 

 Clicking the "Submit Request" button at the end of this form will only work if you use
 Microsoft Outlook or Outlook Express for your email.

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

   Send me an email (diane@mokolea.com) requesting the form and I'll send it as a PDF
   attachment.  When you receive my email with the attached PDF questionnaire, all you
   need to do is open it, complete it, save it to your Desktop, and send it back to me as
   an attachment to your email.

*Note: If you do not have Adobe Acrobat then you will have to answer the questions in
  the form of a narrative and email it to me.

Name:       

Address:    

(City, State): 

Phone Numbers:   (Home)    (Cell)

 
Email:        

Number of people in household:

Do you own or rent your home?

Do any members of your household have allergy problems?

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?

 
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?

 
If you've had other pets, how often did they see a vet?

Do you have breeding experience?

 
Do you have show experience?

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)

****Again; the "Submit Request" button will only work if you use Microsoft Outlook or
      Outlook Express for your email.