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to us. |
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***Please have all
boxes filled in.
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| Email
Address: |
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Name: |
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Address: |
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Address: |
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City: |
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State: |
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Zip Code: |
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Home Phone
Number: |
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Work Phone
Number: |
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Do you want a Male, Female or
Either? |
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Are you willing to take a
mix? |
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Are you willing to take an Elderly
Dog? |
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Are you willing to take two
dogs? |
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Are you willing to take a Special Needs
Dog? |
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Do you live in a house, apartment, or
other? |
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What is the number of people in your
household? |
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Does your lease or ordinance have
restrictions? |
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If so, what are the
restrictions? |
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Do you Rent or
Own? |
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Why do you wish to
adopt a Scottish
Terrier? |
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Do you have a
Fence? |
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Fence Type &
Height? |
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Do you have a pool or other open body of
water? |
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Is the pool / open water area
fenced? |
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Do you have children? How
Many? |
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What are the Children's
Ages? |
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Will any other children come into
contact with the dog? If so, what are the children's
ages? |
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Where will this dog be during the
day?
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Where will the dog be at
night? |
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How many hours will the dog be
alone? |
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Who will care for the dog while you are
on vacation? |
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Who will be the dog's primary
caretaker? |
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Age of Primary
caretaker? |
Under 21 |
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21-35 |
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35-65 |
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Over 65 |
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Veterinary
Reference: |
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Please list all the pets you own, their
gender, age, or whether or not they have been spayed or
neutered |
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Have you ever owned a Scottish
Terrier? |
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Have you ever owned a dog or another
breed? |
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If so, what happened to it or
them? |
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Please use this space for any additional
comments. |
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I
ACKNOWLEDGE THAT ALL THE INFORMATION CONTAINED ON
THIS ONLINE APPLICATION IS TRUE AND CORRECT. I UNDERSTAND
AND AGREE TO PAY AN ADOPTION FEE TO HELP DEFRAY MEDICAL
COSTS.
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