| HAMPSHIRE COUNTY PET ADOPTION PROGRAM |
| Please feel free to print out the appropriate copy of our application and bring it to PetSmart in Winchester, VA on Saturdays between 11:00am and 4:00pm. If you live far away you can fax or mail us your application to be approved before you drive the distance. We will need to talk with you on the phone to be approved, as well. |
| "Hero's Dream" JIM BRICKMAN |
| (You MUST initial & date this application--- as well as fill out EVERY question, if the question does not pertain to you, then put N/A in the blank. Any question left blank will cause a delay in processing your application or potentially cause the application to be denied. NO EXCEPTIONS! Thank you.) |