Diamond Dog Survey

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(Maximum response 255 chars, approx. 5 rows of text)

2. Applicant information

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Name:

 

 

   

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City/State/ZIP:

 

    

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Date of Birth:

 

 

What's this?

*3.

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*4.

(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

*15.

(Maximum response 255 chars, approx. 5 rows of text)

*16.

*17. How did you hear about the dog(s) you are interested in?
(Select one of the available choices or enter a different value.)



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