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YOUR INFORMATION

All information received will remain confidential.

Required: *Phone number with a working voicemail through which we will contact you regarding this application and through which you will be readily available while your pets are at Tails of Hope. *Active email address for follow-up and transmission of application documents.

Once approved and appointment is made, applicant will need to be present at appointment for pet admission.

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* 1. YOUR CONTACT INFORMATION: Where you live with your pets. (P.O. Boxes not allowed.)

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* 2. I currently:

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* 3. Are you currently employed?

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* 4. Check all of the following benefits that you or someone in your household are currently receiving:

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