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Adoption application
Your full name
Email
Phone number
Mobile number
Full address
Post code
Have you any disabilities?
No
Yes
If yes please give details
What dog are you interested in?
Where did you see it?
Have you had a dog before?
Yes
No
If yes what happened to it?
Have you any mental issues?
No
Yes
Age range
18-22
22-26
26-30
30-34
40-45
45-49
49-55
55-60
60-70
70-80
Older
Are there any kids in your household?
If yes please give details age amount etc
Work status
Employed full time
Employed part-time
Unemployed
On pension
How did you hear about Leicestershire Dogs?
About where you live
It's a flat
It's a house
It's a bungalow
It's a Room
About where you live
I own it
I'm renting
Staying with friends
Staying with family
If renting did you get permission from your landlord to keep a dog?
Yes
No
We need two references can you provide 2 referees?
Yes
No
Character referee full address ,name and number
Professional referee full address, name and number
If the adoption wasn't working out what would you do with the dog?
Sell it
give it away
Return it to leicestershire Dogs
How would you confine the dog to your property?
Tie out chain
In a garage
In a cage
in and out at will
Hane you a gaeden?
Yes
No
Have you read our terms and conditions?
Yes
No
I agree to Leicestershire Dogs terms and conditions
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