Country Hill Animal Shelter - Pre Home Check Form
Please fill out this form and one of our team will be in touch
Date
*
-
Month
-
Day
Year
Date
Title
*
Please Select
Mr
Mrs
Miss
Ms
Prefer not to say
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone Number
*
Email
example@example.com
Describe your home
*
Please Select
House
Bungalow
Flat
Ground Floor Flat
Other
Do you own or rent?
*
Please Select
Own
Rent
If you are renting, does your landlord permit you to have pets?
Please Select
Yes, I have landlord consent
No, I do not have landlord consent
I am in the process of getting landlord consent
Can you describe what the surrounding roads are like?
*
Eg., busy/rural/cul de sac
How long have you lived at this address?
*
eg., 2 years and 5 months
Do you plan to move within the next year?
*
Yes
No
Do you have a garden?
*
Please Select
Yes - a small garden
Yes - a medium garden
Yes - a large garden
No - I do not have a garden
Do you have a cat flap?
*
Please Select
Yes
No, I am prepared to fit one
No, I won't be able to fit one
How many adults are in your household?
*
Please Select
1
2
3
4
5
6
7
8
9+
How many children are in your household?
*
Please Select
0
1
2
3
4
5
6
7
8
9+
If applicable, what are the ages of your children?
Do you work?
*
Please Select
Yes - Full time
Yes - Part time
No
At most, how many hours will the cat/s be left during the day?
*
Pets currently owned, species and how many?
*
Have you owned a cat before?
*
Yes
No
Where will the cat/s sleep at night?
*
Do you have plans to go on holiday in the next 8 week?
*
Please Select
Yes
No
When you go on holiday, who will look after the cat/s?
*
How many cats would you like to adopt?
*
Please Select
Only 1
2
Not sure
Prefered age range
*
Please Select
Kitten (Under 1 year)
Young (1-2 years)
Adult (2-8 years)
Senior (8+ years)
No preference
Prefered Personality
*
Affectionate/cuddly
Playful/high-energy
Calm/laid-back
Independent
Working/barn cat
No Preference
Notes
Submit
Should be Empty: