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First Name

Last Name

Email Address

Street Address

City

State

Zip Code

Telephone Number

Have you ever cared for a cat with special needs or a pre-existing medical condition?

Yes No

If so, please explain.

Preferred gender

Neutered male Spayed female Don't care

Preferred color

Sable Champagne Platinum Blue Don't care

Declawed?

Yes No Don't Care

Does it need to get along with other cats?

Yes No

How many other cats?


Does it need to get along with dogs?

Yes No

If yes to the question above, how many?


Do you have children?

Yes No

If yes to the question above, what ages are they?


Most Burmese cats, if kept indoors, live to be quite old. Which age range could you deal with?

four years old and under five to eight years old nine plus years old Don't care

Any further information to help us match you to a rescued Burmese cat?