Which dog are you interested in?
              
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                    Dice 
                  
                    Frisbee 
                  
                    Milo 
                  
                    Petunia 
                  
                    Another dog 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Do you want to adopt or foster the dog?
              
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              Your name
              
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                    First Name 
                   
                
                
                  
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
              
                
            
              Email
              
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              Mobile phone
              
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                    (###) 
                   
                
                
                  
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              Address
              
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                This is where the dog will be living.
                
                  
                    Address 1 
                   
                
                
                  
                    Address 2 
                   
                
                
                  
                    City 
                   
                
                
                  
                    State/Province 
                   
                
                
                  
                    Zip/Postal Code 
                   
                
                
                  
                    Country 
                   
                
               
            
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              What is your level of experience working with or caring for animals?
              
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              Have you adopted or rescued a dog before?
              
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                Check all that apply.
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Do you need a dog that's already had some training?
              
             
          
                
                
                  
                
                  
                
                  
                
               
            
            
            
            
            
            
            
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              The humans in your home
              
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                Tell us about the adult(s) and children who live in your home, full-time or part-time. Share ages (children only), experience with dogs, comfort level, etc. Is everyone in your home onboard with getting a new dog?
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              The animals in your home
              
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                Tell us about any animals (dogs, cats, birds, etc.) in your home, full-time or part-time. Share ages, breeds, genders, personalities, medical needs, etc. Are they spayed/neutered and up to date on vaccinations?
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Has anyone in your household ever been charged with animal cruelty?
              
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              Do you own or rent your home?
              
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              Does your insurance (homeowners or renters) cover dogs?
              
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              Is your property gated &/or fence protected?
              
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              Will you agree to a home check?
              
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              On a typical day, how long will the dog be left alone?
              
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              Where will the dog sleep at night?
              
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                Check all that apply.
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              What type of exercise will the dog get?
              
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                Check all that apply.
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Will the dog be crate trained?
              
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              Provide the contact info for your veterinarian.
              
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                Enter "N/A" if you don't have a veterinarian.
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Provide a personal reference (name, relationship, contact info).
              
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              How long have been with this employer (or been retired)?
              
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              Anything else?
              
             
          
                Thank you so much for your interest in one of our dogs and for sharing your information with us. Is there anything else you’d like us to know about you, your home, or what you’re looking for in a canine companion? We’d love to hear anything that will help us make the perfect match!
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Verification
              
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