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<br />.' <br /> <br />~eA~ ifQl!.fI(ix. <br />, M;//ft g@CJmn.t~/~!.rn.~@lJ.trRh <br />l~1J 1i3..1):/)}~~ <br />Prrin'-t:.t!llJi MNI m*'lj <br />Z~$~~~~.: l.l~ <br />. .. . <br />. .' " .. " . .' ~. <br />. . . . <br /> <br />Too Much of a Good Thing. <br />Spay and Neuter Your Pets . <br /> <br />" ..... ", ..'. . <br /> <br />. ,',. <br />. .. <br /> <br />pale W7 <br /> <br />Mame (i:;r.) I'~ ' Breed~;+Z~ <br />Coat !fhtf ~ -) uJ1Il;r <br /> <br />ADOPTION FORM <br /> <br />Sex #1 <br />Tail ti ~I <br /> <br />PJtered'-jL- Age#- <br />.... ' <br />. ~ ' <br />Housebroke. " <br /> <br />Good wI children <br /> <br />Good wI other animalg V <br />. . / <br /> <br />Dog Food CurrentI:} Eating t?:,.... '1...1 r/ .J,j- ,-H; f ~j <br />. ,., <br /> <br />.... ~/ <br />Intra-Trac III Bordetella dates ~ ,,2 J/6- 7 <br /> <br />Rabies Tag :# <br /> <br />Clinic Issued <br /> <br />Any Other Vaccinations <br /> <br />, Dewol'Ining Schedule: <br /> <br />Nemex (pyrantel pamoate) 9,j3/J7 <br />lvermectin <br /> <br />Fenbendazole <br /> <br />Any Other Medications <br /> <br />, .' <br /> <br />Comments <br /> <br />! ' <br /> <br />8l?-plication Profile <br /> <br />Purpose for adopting this animal <br /> <br />Po you have a fenced 1jard? {VO If so please describe the type and height <br />, Approximately how man:} hours a da:} will the dog be left alone inside? 5 1 Irs- Outside?--8-: <br />PIeasa _ your housing --e (h~. apt. condo. ,,~. etc.) lfU'(f- .lJ(j~ <br />Do you awn or rent? 0[(/ rJ , If you rent, are pets allowed in '!lour rental agreement? <br /> <br />~ . ----- <br /> <br />If you rent, name and phone number of Landlord <br /> <br />-187- <br />