Nina Beans Meet & Greet Questionnaire
Bestie, is that you?
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What type of residence is this?
*
Please Select
House
Condo
Apartment
Phone Number
*
E-mail
*
example@example.com
How did you hear about Nina Beans?
*
Please Select
Instagram
Facebook
TikTok
Safe Humane Chicago PALS
Other
Please Specify
*
Do you currently have pets in your household? If so which kind?
*
How many people are in your current household? Please list adults and age of children:
*
Have you had pets in the past? If so which kind and for how long?
*
How much time are you able and willing to give in regards to training and fulfillment per day?
*
How would you describe your current lifestyle: Low activity, Moderate Activity, Very Active?
*
Please Select
Low activity
Moderate Activity
Very Active
Please give reference of any three people whom you feel:
*
Full Name
Contact Phone Number
Contact Email
1
2
3
Submit
Should be Empty: