Name

Title
—Please choose an option—MrMrsMissMs

First name

Last name

Address & Contact Details

House number and street

Town

City

County

Post code

Mobile number

Home number

Email Address

Accommodation Details

House type:
—Please choose an option—House (semi / detached / terraced)Flat or maisonette (with direct outside access)Flat or maisonette (without direct outside access)Bungalow

Status:
—Please choose an option—Home ownerPrivate tenantCouncil tenant

Please note that if you are in Private Rental Accommodation you must have written permission from your Landlord before we can organise a home visit.

No. of people living at the address:
—Please choose an option—0123456789+

No. of children under 18 living at the address:
—Please choose an option—0123456789+

Children's ages:

Existing Pets

Do you have any cats?
—Please choose an option—NoYes - NeuteredYes - Not Neutered

Number of Cats

Gender(s) of your current cat(s)?
—Please choose an option—MaleFemaleMixed

Do you have any rabbits?
—Please choose an option—NoYes - neuteredYes - not neutered

Number of Rabbits:

Gender(s) of your current rabbit(s)?
—Please choose an option—MaleFemaleMixed

Do you have any guinea pigs?
—Please choose an option—NoYes - NeuteredYes - Not Neutered

Number of Guinea Pigs:

Gender(s) of your current guinea pig(s)?
—Please choose an option—MaleFemaleMixed

Do you have any other pets, and if so please specify what and how many?

Rabbit Adoption Details

What are you looking to adopt and why?

Where will your rabbit(s) live and/or have access to?
—Please choose an option—HouseGardenBoth

Do you have rabbit accommodation in place?
YesNo

If yes please give a brief description and sizes here.

If you have your accommodation please attach a few photos of it :

• If inside then a photo of the whole area the rabbits have 24 hour access too

• If outside then the photo of the combined hutch and run

• If possible photos showing the measurements (eg with a tape measure)

• A couple of photos to a get a feel for the accommodation

Other Information

Any other information we need to know that is relevant?

How did you hear about us?

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Yes

Agreement with our Policies

I have read and agree with the adoption policy. Read here
I have read and agree with the adoption fees. Read here

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