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DC Rescue Dogs is completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive complete medical care, which includes vaccinations, spaying\/neutering, microchipping and registration prior to their adoption.<\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_text\" id=\"id_76\">\n        <div id=\"cid_76\" class=\"form-input-wide\">\n          <div id=\"text_76\" class=\"form-html\" data-component=\"text\">\n            <p>This questionnaire is designed to help DC Rescue Dogs and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. DC Rescue Dogs selects the most suitable home for each dog, and it is not first in first served. By filling in this form, you are not guaranteed to adopt the dog you have requested.<\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_19\" class=\"form-input-wide\" data-type=\"control_head\">\n        <div class=\"form-header-group \">\n          <div class=\"header-text httal htvam\">\n            <h2 id=\"header_19\" class=\"form-header\" data-component=\"header\">\n              Applicant Information\n            <\/h2>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_6\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_6\" for=\"input_6\">\n          Name of the dog you are interested in:\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_6\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_6\" name=\"q6_nameOf\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"30\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_0\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_0\" for=\"input_0\">\n          Your full name:\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_0\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_0\" name=\"q0_yourFull\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"30\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textarea\" id=\"id_8\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_8\" for=\"input_8\">\n          Street Address:\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_8\" class=\"form-input jf-required\">\n          <textarea id=\"input_8\" class=\"form-textarea validate[required]\" name=\"q8_streetAddress\" cols=\"30\" rows=\"1\" data-component=\"textarea\" required=\"\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_88\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_88\" for=\"input_88\">\n          City\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_88\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_88\" name=\"q88_city\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"40\" value=\"\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_phone\" id=\"id_83\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_83\" for=\"input_83_area\"> Contact Phone: <\/label>\n        <div id=\"cid_83\" class=\"form-input\">\n          <div data-wrapper-react=\"true\">\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"tel\" id=\"input_83_area\" name=\"q83_contactPhone[area]\" class=\"form-textbox\" size=\"3\" value=\"\" data-component=\"areaCode\" \/>\n              <span class=\"phone-separate\">\n                \u00a0-\n              <\/span>\n              <label class=\"form-sub-label\" for=\"input_83_area\" id=\"sublabel_area\" style=\"min-height:13px;\"> Area Code <\/label>\n            <\/span>\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"tel\" id=\"input_83_phone\" 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id=\"header_20\" class=\"form-header\" data-component=\"header\">\n              Household Information\n            <\/h2>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_22\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_22\" for=\"input_22\">\n          Who will be the pet's primary caregiver?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_22\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_22\" name=\"q22_whoWill\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"30\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_radio\" id=\"id_23\">\n        <label class=\"form-label form-label-left form-label-auto\" 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class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio\" id=\"input_26_1\" name=\"q26_doesYour\" value=\"No\" \/>\n              <label id=\"label_input_26_1\" for=\"input_26_1\"> No <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_checkbox\" id=\"id_27\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_27\" for=\"input_27_0\">\n          Are there any restrictions from your landlord or subdivision?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_27\" class=\"form-input jf-required\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_27_0\" name=\"q27_areThere[]\" value=\"Number of pets\" required=\"\" \/>\n              <label id=\"label_input_27_0\" for=\"input_27_0\"> Number of pets <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_27_1\" name=\"q27_areThere[]\" value=\"Size or weight restrictions\" required=\"\" \/>\n              <label id=\"label_input_27_1\" for=\"input_27_1\"> Size or weight restrictions <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_27_2\" name=\"q27_areThere[]\" value=\"Breed restrictions\" required=\"\" \/>\n              <label id=\"label_input_27_2\" for=\"input_27_2\"> Breed restrictions <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_27_3\" name=\"q27_areThere[]\" value=\"None\" required=\"\" \/>\n              <label id=\"label_input_27_3\" for=\"input_27_3\"> None <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_radio\" id=\"id_28\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_28\" for=\"input_28\">\n          Do you have a fully fenced yard?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_28\" class=\"form-input jf-required\">\n          <div class=\"form-single-column\" data-component=\"radio\">\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_28_0\" name=\"q28_doYou28\" value=\"Yes\" required=\"\" \/>\n              <label id=\"label_input_28_0\" for=\"input_28_0\"> Yes <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_28_1\" name=\"q28_doYou28\" value=\"No\" required=\"\" \/>\n              <label id=\"label_input_28_1\" for=\"input_28_1\"> No <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textbox\" id=\"id_29\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_29\" for=\"input_29\"> Height and type of fence <\/label>\n        <div id=\"cid_29\" class=\"form-input\">\n          <input type=\"text\" id=\"input_29\" name=\"q29_heightAnd\" data-type=\"input-textbox\" class=\"form-textbox\" size=\"30\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_checkbox\" id=\"id_30\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_30\" for=\"input_30_0\"> Do you have any of the following? Please tick all that apply. <\/label>\n        <div id=\"cid_30\" class=\"form-input\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_30_0\" name=\"q30_doYou30[]\" value=\"Kennel &amp; Run\" \/>\n              <label id=\"label_input_30_0\" for=\"input_30_0\"> Kennel & Run <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_30_1\" name=\"q30_doYou30[]\" value=\"Crate\" \/>\n              <label id=\"label_input_30_1\" for=\"input_30_1\"> Crate <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_number\" id=\"id_85\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_85\" for=\"input_85\">\n          How many adults are in your household?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_85\" class=\"form-input jf-required\">\n          <input type=\"number\" id=\"input_85\" name=\"q85_howMany\" data-type=\"input-number\" class=\" form-number-input form-textbox validate[required, Numeric]\" style=\"width:60px;\" size=\"5\" value=\"\" placeholder=\"ex: 23\" data-component=\"number\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_number\" id=\"id_86\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_86\" for=\"input_86\">\n          How many children are in your household?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_86\" class=\"form-input jf-required\">\n          <input type=\"number\" id=\"input_86\" name=\"q86_howMany86\" data-type=\"input-number\" class=\" form-number-input form-textbox validate[required, Numeric]\" style=\"width:60px;\" size=\"5\" value=\"\" placeholder=\"ex: 23\" data-component=\"number\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textbox\" id=\"id_37\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_37\" for=\"input_37\"> If children, what are their ages? <\/label>\n        <div id=\"cid_37\" class=\"form-input\">\n          <input type=\"text\" id=\"input_37\" name=\"q37_ifChildren\" data-type=\"input-textbox\" class=\"form-textbox\" size=\"20\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_radio\" id=\"id_38\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_38\" for=\"input_38\"> Have your children been around animals before? <\/label>\n        <div id=\"cid_38\" class=\"form-input\">\n          <div class=\"form-single-column\" data-component=\"radio\">\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio\" id=\"input_38_0\" name=\"q38_haveYour\" value=\"Yes\" \/>\n              <label id=\"label_input_38_0\" for=\"input_38_0\"> Yes <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio\" id=\"input_38_1\" name=\"q38_haveYour\" value=\"No\" \/>\n              <label id=\"label_input_38_1\" for=\"input_38_1\"> No <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_radio\" id=\"id_39\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_39\" for=\"input_39\">\n          Does anyone in your home have allergies to dogs or have asthma?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_39\" class=\"form-input jf-required\">\n          <div class=\"form-single-column\" data-component=\"radio\">\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_39_0\" name=\"q39_doesAnyone\" value=\"Yes\" required=\"\" \/>\n              <label id=\"label_input_39_0\" for=\"input_39_0\"> Yes <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_39_1\" name=\"q39_doesAnyone\" value=\"No\" required=\"\" \/>\n              <label id=\"label_input_39_1\" for=\"input_39_1\"> No <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_42\" class=\"form-input-wide\" data-type=\"control_head\">\n        <div class=\"form-header-group \">\n          <div class=\"header-text httal htvam\">\n            <h2 id=\"header_42\" class=\"form-header\" data-component=\"header\">\n              Current\/Previous Pet Information\n            <\/h2>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textarea\" id=\"id_93\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_93\" for=\"input_93\"> Please let us know a little about what previous dog experience you have - dogs you've owned or other peoples dogs you may have cared for or interacted with. <\/label>\n        <div id=\"cid_93\" class=\"form-input\">\n          <textarea id=\"input_93\" class=\"form-textarea\" name=\"q93_pleaseLet\" cols=\"40\" rows=\"6\" data-component=\"textarea\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textarea\" id=\"id_44\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_44\" for=\"input_44\"> List any other pets on the property (name, breed, species) <\/label>\n        <div id=\"cid_44\" class=\"form-input\">\n          <textarea id=\"input_44\" class=\"form-textarea\" name=\"q44_listAny44\" cols=\"30\" rows=\"2\" data-component=\"textarea\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textbox\" id=\"id_89\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_89\" for=\"input_89\"> Are there any dogs on the property that have not been desexed? <\/label>\n        <div id=\"cid_89\" class=\"form-input\">\n          <input type=\"text\" id=\"input_89\" name=\"q89_areThere89\" data-type=\"input-textbox\" class=\"form-textbox\" size=\"20\" value=\"\" data-component=\"textbox\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textarea\" id=\"id_92\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_92\" for=\"input_92\"> Are there any dogs on the property who have behavioural challenges? If so, please provide some information about these challenges. <\/label>\n        <div id=\"cid_92\" class=\"form-input\">\n          <textarea id=\"input_92\" class=\"form-textarea\" name=\"q92_areThere92\" cols=\"40\" rows=\"6\" data-component=\"textarea\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_radio\" id=\"id_79\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_79\" for=\"input_79\"> Have you ever given up a pet? <\/label>\n        <div id=\"cid_79\" class=\"form-input\">\n          <div class=\"form-single-column\" data-component=\"radio\">\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio\" id=\"input_79_0\" name=\"q79_haveYou79\" value=\"Yes\" \/>\n              <label id=\"label_input_79_0\" for=\"input_79_0\"> Yes <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio\" id=\"input_79_1\" name=\"q79_haveYou79\" value=\"No\" \/>\n              <label id=\"label_input_79_1\" for=\"input_79_1\"> No <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textarea\" id=\"id_80\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_80\" for=\"input_80\"> If yes, what were the circumstances? <\/label>\n        <div id=\"cid_80\" class=\"form-input\">\n          <textarea id=\"input_80\" class=\"form-textarea\" name=\"q80_ifYes80\" cols=\"40\" rows=\"6\" data-component=\"textarea\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li id=\"cid_51\" class=\"form-input-wide\" data-type=\"control_head\">\n        <div class=\"form-header-group \">\n          <div class=\"header-text httal htvam\">\n            <h2 id=\"header_51\" class=\"form-header\" data-component=\"header\">\n              New Pet Information\n            <\/h2>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textarea\" id=\"id_53\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_53\" for=\"input_53\">\n          What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_53\" class=\"form-input jf-required\">\n          <textarea id=\"input_53\" class=\"form-textarea validate[required]\" name=\"q53_whatType\" cols=\"30\" rows=\"2\" data-component=\"textarea\" required=\"\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_58\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_58\" for=\"input_58\">\n          How many hours each day will your new pet be home alone?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_58\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_58\" name=\"q58_howMany58\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"20\" value=\"\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textarea\" id=\"id_72\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_72\" for=\"input_72\">\n          How much exercise, and what type of exercise would your new dog get each day?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_72\" class=\"form-input jf-required\">\n          <textarea id=\"input_72\" class=\"form-textarea validate[required]\" name=\"q72_howMuch\" cols=\"40\" rows=\"6\" data-component=\"textarea\" required=\"\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_59\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_59\" for=\"input_59\">\n          Where will your new pet sleep at night?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_59\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_59\" name=\"q59_whereWill\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"20\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_textbox\" id=\"id_61\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_61\" for=\"input_61\">\n          Where will your new dog stay when nobody is home?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_61\" class=\"form-input jf-required\">\n          <input type=\"text\" id=\"input_61\" name=\"q61_whereWill61\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" size=\"20\" value=\"\" placeholder=\" \" data-component=\"textbox\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_radio\" id=\"id_65\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_65\" for=\"input_65\">\n          Do you understand that a dog can be an 18 year commitment, and can be expensive to care for at times?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_65\" class=\"form-input jf-required\">\n          <div class=\"form-single-column\" data-component=\"radio\">\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_65_0\" name=\"q65_doYou65\" value=\"Yes\" required=\"\" \/>\n              <label id=\"label_input_65_0\" for=\"input_65_0\"> Yes <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_65_1\" name=\"q65_doYou65\" value=\"No\" required=\"\" \/>\n              <label id=\"label_input_65_1\" for=\"input_65_1\"> No <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_radio\" id=\"id_66\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_66\" for=\"input_66\">\n          Do you plan to take an obedience class with your dog?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_66\" class=\"form-input jf-required\">\n          <div class=\"form-single-column\" data-component=\"radio\">\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_66_0\" name=\"q66_doYou66\" value=\"Yes\" required=\"\" \/>\n              <label id=\"label_input_66_0\" for=\"input_66_0\"> Yes <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_66_1\" name=\"q66_doYou66\" value=\"No\" required=\"\" \/>\n              <label id=\"label_input_66_1\" for=\"input_66_1\"> No <\/label>\n            <\/span>\n            <span class=\"form-radio-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_66_2\" name=\"q66_doYou66\" value=\"Not sure\" required=\"\" \/>\n              <label id=\"label_input_66_2\" for=\"input_66_2\"> Not sure <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_textbox\" id=\"id_68\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_68\" for=\"input_68\"> If yes, where? <\/label>\n        <div id=\"cid_68\" class=\"form-input\">\n          <input type=\"text\" id=\"input_68\" name=\"q68_ifYes68\" data-type=\"input-textbox\" class=\"form-textbox\" size=\"20\" value=\"\" maxlength=\"100\" placeholder=\" \" data-component=\"textbox\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_checkbox\" id=\"id_73\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_73\" for=\"input_73_0\">\n          How did you find out about DC Rescue?\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_73\" class=\"form-input jf-required\">\n          <div class=\"form-multiple-column\" data-columncount=\"2\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_73_0\" name=\"q73_howDid[]\" value=\"TradeMe\" required=\"\" \/>\n              <label id=\"label_input_73_0\" for=\"input_73_0\"> TradeMe <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_73_1\" name=\"q73_howDid[]\" value=\"PetsOnTheNet\" required=\"\" \/>\n              <label id=\"label_input_73_1\" for=\"input_73_1\"> PetsOnTheNet <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_73_2\" name=\"q73_howDid[]\" value=\"Facebook\" required=\"\" \/>\n              <label id=\"label_input_73_2\" for=\"input_73_2\"> Facebook <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_73_3\" name=\"q73_howDid[]\" value=\"Friend\/Family Member\" required=\"\" \/>\n              <label id=\"label_input_73_3\" for=\"input_73_3\"> Friend\/Family Member <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_73_4\" name=\"q73_howDid[]\" value=\"Hamilton Vets\" required=\"\" \/>\n              <label id=\"label_input_73_4\" for=\"input_73_4\"> Hamilton Vets <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <label style=\"display:none;\" for=\"other_73\"> Other option <\/label>\n              <input type=\"checkbox\" class=\"form-checkbox-other form-checkbox validate[required]\" name=\"q73_howDid[other]\" id=\"other_73\" value=\"other\" \/>\n              <input type=\"text\" class=\"form-checkbox-other-input form-textbox\" name=\"q73_howDid[other]\" data-otherhint=\"Other\" placeholder=\"Other\" size=\"15\" id=\"input_73\" \/>\n              <br\/>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_text\" id=\"id_75\">\n        <div id=\"cid_75\" class=\"form-input-wide\">\n          <div id=\"text_75\" class=\"form-html\" data-component=\"text\">\n            <p>I understand that I assume full responsibility for the welfare of this pet from the date of adoption. Should I ever have to give up this dog, I will contact DC Rescue Dogs first.<\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_checkbox\" id=\"id_90\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_90\" for=\"input_90_0\"> Newsletter <\/label>\n        <div id=\"cid_90\" class=\"form-input\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_90_0\" name=\"q90_newsletter[]\" value=\"Yes, subscribe me to this newsletter.\" \/>\n              <label id=\"label_input_90_0\" for=\"input_90_0\"> Yes, subscribe me to this newsletter. <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_button\" id=\"id_1\">\n        <div id=\"cid_1\" class=\"form-input-wide\">\n          <div style=\"margin-left:156px;\" class=\"form-buttons-wrapper\">\n            <button id=\"input_1\" type=\"submit\" class=\"form-submit-button\" data-component=\"button\">\n              Submit\n            <\/button>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li style=\"display:none\">\n        Should be Empty:\n        <input type=\"text\" name=\"website\" value=\"\" \/>\n      <\/li>\n    <\/ul>\n  <\/div>\n  <script>\n  JotForm.showJotFormPowered = \"old_footer\";\n  <\/script>\n  <input type=\"hidden\" id=\"simple_spc\" name=\"simple_spc\" value=\"71152646073857\" \/>\n  <script type=\"text\/javascript\">\n  document.getElementById(\"si\" + \"mple\" + \"_spc\").value = \"71152646073857-71152646073857\";\n  <\/script>\n<\/form><\/body>\n<\/html>\n"," Rescue Dog Adoption Application",Array,0);(function(){window.handleIFrameMessage=function(e){if(!e.data||!e.data.split)return;var args=e.data.split(":");var iframe=document.getElementById("71152646073857");if(!iframe){return};switch(args[0]){case"scrollIntoView":if(!("nojump"in FrameBuilder.get)){iframe.scrollIntoView();}
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