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* Indicates required field

Name *

First

Last

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Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

1. I am interested in *

A Pet Only A Breeder

2. Sex of Kitten *

Male Female Does not matter/undecided

3. Do you have Cat Allergies in the Family? *

No Yes, Adult Yes, Child Yes, but they do NOT live with us

4. Allergy Symptoms (check if any apply) *

Occasional/not all cats Mild (I can live with them) Moderate (sneezing, stuffy nose) **Severe (red/itchy eyes/skin) **I have Asthma

5. I am allergic to?? (Choose all that apply) If you are allergic to Horses, Rabbits or Eggs; you are having a reaction to (Fel d 4). Siberians are only low in Fel d 1 so if you are allergic to any of these three things then you have a 50/50 chance of being allergic to a Siberian. *

Dogs Eggs Horses Rabbits None of the Above

6. Do you use an inhaler? *

Yes No

7. Do you have children? *

Yes No

8. Children's Age *

No Children 0-2 3-5 6-10 11-16 Grown Children

9. Number & type of pets in the home *

10. Why a Siberian and what do you know about them? *

11. Do you consider yourself to be experienced with cats? *

12. Do you plan to Declaw your cat? *

Yes No

13. Do you have a busy home or a quiet home? This info helps me to offer the best kitten(s) for you. *

14. Will this cat be used as a Therapy or Emotional Support animal? *

15. Not all cats are lap cats. Some just like to hang out and be near you. Would this type of cat be an option for you? *

Yes No

16. Is there a person living in the home in military service that may qualify for a discount? *

Yes No

17. How did you hear about us? *

18. Are you requesting a Allergy test? Fee $50 for 1 hour. The testing fee goes towards the deposit. If no deposit is made then the fee is just for my time. Testing is done in Kingman AZ by appointment on Saturdays and Sundays unless other arrangements are made. *

Yes No

19. Comments? Questions? *

There are very few reputable breeders in the Western part of the US. I receive 5-10 kitten applications per day. Please allow 2-3 days for response back. I will reply just as soon as possible :) .

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