One at a Time K-9 Rescue Adoption Application



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Have you ever owned a pet before? *

Please provide the name and phone number of the veterinarian for your pets.

How many people reside in your household?
Does anyone have allergies? *
Does anyone smoke? *
Do you own or rent your residence? If rent, please provide the name and phone number of your landlord below. *
What type of home do you live in? *
 
Does your residence have a yard? *
Is your yard fenced? *
 
Where will the dog stay during the day? *
Where will the dog stay at night? *
Will anyone be home during the day? *


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I represent that the information that I have provided on this form is the truth to the best of my knowledge and belief.

Signed: *
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