Form test Your Full Name (First and Last)* Your Email* Your Phone Number* Cell or Work Phone Number Your Address (Please include City and Zip Code)* Do you own or rent?* Number of people in your home?* Number of children in your home? (Please include ages) If no children living in your home, do children visit frequently? (grandchildren, friend's children, etc) Do you have an active/busy home (lots of coming and going, frequent visitors) or is your home quiet and calm, without frequent visitors?* Do you have a fenced-in yard?* Type of fence? Height? Will pet live inside, outside, or both?* Will pet need to use the stairs?* Is there a specific dog that interests you? What are you looking for in a dog?* Are you open to adopting a dog that doesn't get along with other dogs?* Please list your current pets with a description and age of each.* Please list pets you have previously had, and why they are no longer with you. Name and phone number of your current veterinarian?* Name and phone number of previous veterinarian(s)?* What do you do for a living?* How do you correct unwanted behaviors in a pet? Please give an example.* How did you find out about Hallie Hill?* I declare that the above is true to the best of my knowledge and ability. By submitting this application, I authorize the veterinarian listed to release any medical information of my current or previous pets. I also read the note displayed above this application.