K9FW (PV) - Dog Donation Application 11 months - 4 years old

Date

mm/dd/yyyy

First Name

Last Name

Address

State

Zip Code

Phone Number

Email Address

Preferred Contact Method

Dog's Name

Gender

Breed

Approximate Age/Date of Birth

Approximate Weight

Dogs must be between 50 and 90 pounds

Approximate height to the dogs front shoulder

Dogs must be between 22" and 27" tall from the floor to the front shoulder to meet our requirements.

Where did you acquire the dog?

Is your dog up to date on medical?

Please upload medical documents and pictures of your dog

Please upload your most recent medical records along with a picture of you dog. Medical records need to show all vaccine history along with an updated heartworm test.

Drop your files here

Are you able to transport to our facility?

Is your dog house trained?

Is your dog good around other dogs?

Is your dog good around cats?

Is your dog good around children?

Please choose your dogs activity level.

Please provide any additional details we may need

Send me a copy of my responses

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