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Escape to the Country application form

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*Required information

*First name

*Surname

Other members of the family involved in the move and ages

*Current address

What new activities would you like to take up after you move?

*Home phone number

Mobile phone number

Work phone number

*Email address

Occupation

Details of current property (e.g. 3 bedrooms, modern house on a busy main road)

What type of house are you looking for? (e.g. detached, semi, terrace, flat)

Number of bedrooms

House style, e.g. modern, cottage, traditional

Would you like somewhere in need of renovation? Yes No

What is your maximum budget?

Which location do you want to move to?

When are you hoping to move?

Please give 3 reasons why you want to move

What concerns do you have about the move?

How will this affect your present employment?

Which 3 amenities are essential for the location?
(e.g. schools, rural, motorway access)

Which 3 criteria are essential for the house?
(e.g. land, study, beams)

Would you be happy for your details to be passed on to other Boundless productions? Yes No

The information you provide will be collected and compiled by the production team for the next series of Escape to the Country. They will only use your personal details for the purposes of contacting you about the programme. Your personal information will be treated in accordance with the Data Protection Act 1998. Please see the BBC's Privacy and Cookies Policy for more information.

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