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Your Information

First Name:
Last Name:
Street Address:
City:
Province:
Postal Code:
Major Cross-Streets:
Day Phone:
Evening Phone:
Cell Phone:
Email Address:

Home Information

Homeowners Insurance Provider:
Is someone home full-time?Yes No
Describe your past and present experience with animals?
Do you have a dog safe yard?
*A dog safe yard is completely enclosed with a permanent fence or block wall. It must be secure enough for the guest dog to go to the bathroom without a leash. Describe your backyard in detail.
Yes No
Do you have children in your home? If yes, how old are they?Yes No
Do you have pets in your home? If yes, please give details:Yes No
Are there any regular limitations to the time you would be available to host a pet? Please explain:Yes No
How much exercise would you be able to provide the pet on a daily basis? Please explain:
Do you need to define limitations to the type of dog you would be willing to host? Please explain:Yes No
Would you be willing to host more than one dog at a time?Yes No
Please tell us why you would be a good host for a visiting pet:
Is there anything else you might want us to consider?