Questionnaire

Ref Number

Requested Departure Date

Travelling From

Travelling to

Are you looking to be on the same flight?

Has your pet/s travelled outside the UK? If yes where to and when:-

Your Name

Your Address (UK)

Landline No

Mobile No

If quoted for collection please provide contact details and address below, if different from the above:

UK Emergency contact Name & Telephone number in case of your pet/s being off-loaded from the flight.

Receivers Name

Receivers Address

(Destination address for where your pet/s will be travelling to. This is required for the airline documents)

Int’l Landline No

Int’l Mobile No

Customs Representation at destination (if applicable)

Address

Telephone No

Email address*

Have customs formalities been arranged at destination?

Through a broker/customs agent

Owner or receiver to personally clear pet through customs

PassportforPets to arrange destination services (if quoted)

Name of customs broker/agent at destination

Email address for customs broker/agent at destination:*

Mobile No for customs broker/agent at destination:

Owner/Receiver to clear pet through customs at destination

Yes

Please confirm you are aware of the requirements & that you are responsible for all charges due at destination

Yes

Payment

Bank details below

Account Name: AIRSUPPLY SHIPPING AGENTS LTD

Account Number: 46212523

Bank Sort Code: 04 - 29 - 09

ALL BANK CHARGES ARE TO BE INCLUDED IN PAYMENT SO WE RECEIVE THE FULL AMOUNT AS PER THE QUOTATION AND BOOKING FEE.

PLEASE QUOTE YOUR QUOTATION REFERENCE ON TRANSFER.

NOTE ALL BALANCES MUST BE PAID 30 DAYS PRIOR TO DEPARTURE

PLEASE NOTE – DEPOSIT PAYMENTS ARE NON-REFUNDABLE AS PER OUR T&Cs.

TICK BOX FOR A UK DEBIT CARD (NO ADMIN FEE/ PERSONAL CARD)

TICK BOX FOR A UK CREDIT CARD (NO ADMIN FEE/ PERSONAL CARD)

TICK THIS BOX IF USING AN OVERSEAS CARD/ UK BUSINESS DEBIT CARD/ UK BUSINESS CREDIT CARD (8% ADMIN FEE ADDED)

Please enter the amount you are paying

if travelling within 30 days the full amount is due (non-refundable) or if travel is outside the next 30 days, please enter deposit amount (non-refundable)

Please provide Name on card & address where card is registered.

Pet/s information

Pet No 1

Pets Name

Type

Breed

D.O.B/Age

Neutered

Colour

Gender

Male

Female

Pet No 2

Pets Name

Type

Breed

D.O.B/Age

Neutered

Colour

Gender

Male

Female

Pet No 3

Pets Name

Type

Breed

D.O.B/Age

Neutered

Colour

Gender

Male

Female

PLEASE VERIFY YOUR PETS DIMENSIONS

Pet No 1

Pets Name

Length

Width

Height

Weight

Pet No 2

Pets Name

Length

Width

Height

Weight

Pet No 3

Pets Name

Length

Width

Height

Weight

If providing your own kennel – please confirm measurements, make, model and supply photos.

Make

Model

Kennel weight

External Measurements (Pet no 1)

Length

Weight

Height

External Measurements (Pet no 2)

Length

Weight

Height

External Measurements (Pet no 3)

Length

Weight

Height

Internal Measurements (Pet no 1)

Length

Weight

Height

Internal Measurements (Pet no 2)

Length

Weight

Height

Internal Measurements (Pet no 3)

Length

Weight

Height

I declare that all information provided in this booking form is true and correct. I understand that giving false or incorrect information could result in having to pay additional charges, or the shipment being cancelled (all monies paid may be lost). I can confirm I have read and accept the Terms & Conditions.

Signature *

Clear

Signature*

Printed Name

Date

Pets Name

Owners Name

How is your pet with strangers?

Can your pets share a kennel at the boarding facilities?

Yes

Does your pet mind being handled / examined by the vet?

Is your pet on any medication?

Is your pet on any special diet?

Please provide current vet details:

Name

Address

Telephone Number

Email address*

Can we have permission to contact your vets directly?

Where did you hear about us?

What made you decide to use our services?