Central Texas SPCA

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Dog Waiting List
First Name (*)
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Last Name (*)
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Street Address (*)
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City (*)
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ZIP (*)
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Home Phone (*)
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Work Phone
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Cell Phone
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Email (*)
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Pet Name
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Pet Gender (*)
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Stray
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Spay or Neutered (*)
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Breed
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Hair
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Approximate Age (*)
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Weight (*)



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Please provide a description of the animal's physical appearance, including color
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Please describe anything you know about the animal's personality or quirks
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Good with Kids
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Good with Cats
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Good with Dogs
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House Trained
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Please provide a detailed description of why you are surrendering this animal (*)
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Please provide the following information if you are aware of it. This information is provided for the health of the animal, to prevent double vaccinations. This information is NOT used to determine acceptance. Please be honest.
Yearly Vaccinations
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Rabies Vaccination
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Heart Worm Prevention
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Date of Last Vaccinations
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Name of Veterinarian
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Phone Number of Veterinarian
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Please make sure you have answered all questions indicated with an asterisk. Those questions are mandatory, and failure to answer them will cause you to be returned to this form. When you are sure you are finished, click the SUBMIT button below.
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