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* 1. First & Last Name

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* 2. Phone Number

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* 3. Email Address

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* 4. Current Address

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* 5. Occupation

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* 6. Do you have Children?

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* 7. On a regular basis, how many hours will the dog be left alone?

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* 8. What precautions will you take to introduce your dog into your home if you have other animals?

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* 9. Identify up to 3 pets you would like to adopt.

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