Adoption Application for Dogs Date * I wish to adopt from the following location: * AntigonishCape BretonColchesterDartmouthHantsKingsLa BaieLunenburgPictouQueensYarmouthHRM Animal Redemption Centre I am submitting this application because... * I am ready to adopt now Name of the dog I would like to adopt is: * *Please note - We do not accept preapproval applications or wait lists. Please do not submit your application with a generic description such as 'puppy' or 'small dog' without indicating the name of the dog that is currently listed for adoption. Name * Name First First Last Last Address * Address Address Address City City Province Province Postal Postal Phone * Email * Please list the name of someone who is your emergency contact for the microchip registration file. They will be added as a back up to your microchip contacts in addition to any contact numbers listed above, this should not be someone who lives in the home with you. Phone number for emergency contact Please add me to your free e-newsletter for warm fuzzies Yes No If you are human, leave this field blank. Next
