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Get Bens Giant Rescue Form

Phone: Cell Phone: E-Mail Address: Employer: Title: Do you live in a: (house, apartment, mobile home?) Do you own or rent? If you rent, please provide name/address of landlord so we can verify a pet deposit has been paid and that pets are allowed: How long have you lived at your current address? Do you plan to move in the next 12 months? If so, are you prepared to take this dog with you? Why do you want a dog? Where will this dog be kept when you are not home: (Outside, Crated inside, Inside.

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