Survey sheet – CCC

* Fields marked with an asterisk (*) are required

Name of the first caretaker (you)*

Name of the second caretaker

Name of the third caretaker

If there are more caretakers, please fill in the other information at the bottom

E-mail address

Postal code (ZIP code)*

Your address
-Street number and name

-City

-Province/state

-Country

Phone number* (as indicated in the email you received at the time of application)

Reception number* (found on the email you received when you applied)

- From this point on, please provide the following information about your cat

Name*

Gender*
Male Female Unknown

Neutered/spayed?
Yes No Unknown

Date of birth
Year / Month / Day

Date of death (if already deceased)
Year / Month / Day

Age

Area of residence, location, address, etc*.

Area of birth

Size of cat's territory and location characteristics

Favorite place

Hair pattern*

Breed

Characteristics, such as long hair or short hair

Weight (lbs or kg)

Collar or ribbon
Yes No

Friends, companions or rivals

Number of meals per day

Main type of food (dry, wet, manufacturer, brand, self-catering, etc.)*

Favorite foods and treats

Personality*

Charming points or characteristics

Special skills

Personal story*

Other information

Front image (attach)*
×

Side image (attach)
×

Favorite image (attach)*
×

I swear on my cat that the above is correct and I hereby declare it to be correct