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Millie

14 Years, 7 Months old
Small Crossbreed

Apply Here

About Me

Millie was saved by us before being put to sleep when her owner became unwell.

Millie has daily medication for her heart

Millie is now staying in our care to live in foster, in comfort until her heart gives up.

My Likes and Dislikes

Type of Home I Need

Gallery

Click to open full size images and videos

My Traits

Current Status

Being Assessed

What Next

If you think you can offer Millie the home they deserve then fill in the form below and we'll be in touch as soon as possible. Thank you

Your Details

Page 1 of 8

Progress:

I would like to *

I would like to foster/ adopt a *

Would you prefer long or short-term fosters

Who is you application to Adopt/ Foster for?

Name of Lead Applicant *

Full Address *

Contact Number(s) *

Contact Email *

Employment Information

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Progress:

Are you employed? *
YesNo

Employer

Job Title

Period of Employment

Hours worked per Week

How long will the animal be left?

Are you at risk of becoming unemployed?
YesNo

Please provide details of how you will provide for the animal

Other Pets & Animals

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Progress:

Do you own any other pets? *
YesNo

Names

Breeds

Ages

Genders

Are they all neutered?
YesNo

Is there a reason for not neutering?

Temperaments

Have you ever given an animal away or handed into a rescue? *
YesNo

Please give details

Veterinarian Information

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Progress:

Practice you use/intend to use *

Vets name (if known)

Practice Address *

Practice Telephone Number *

When did you last visit the vets?

Why did you last visit the vets?

Additional Information

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Progress:

Please use this space to tell us anything else about yourself, your family, your home and / or your animals.

Terms & Conditions

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Progress:

By signing below, I certify that the information I have given is true. I understand that Chesterfield Animal Rescue reserves the right to deny my application for any reason. I further authorise the investigation of all statements in this application.
I Agree

If successful do you agree to share your details with Agria for 5 weeks free insurance?
YesNo

Charity Number: 1194151

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Millie

14 Years, 7 Months old
Small Crossbreed

Apply Here

About Me

My Likes and Dislikes

Type of Home I Need

Gallery

My Traits

Current Status

Your Details

Page 1 of 8

Family & Household

Page 2 of 8

Employment Information

Page 3 of 8

Other Pets & Animals

Page 4 of 8

Veterinarian Information

Page 5 of 8

Foster/ Adoption Questions

Page 6 of 8

Additional Information

Page 7 of 8

Terms & Conditions

Page 8 of 8