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Dogs in Leave this field blank Coordinator Details (optional) Welfare Co-ordinator Choose Liz Bradley Karen Clayton Shirley Evans Penny Gutridge Tony and Caroline Hart Jean Hill Cath Marchbank Sarah Masters Rob McLeod Nick Sanders Gill Paul Simms Magda Teale Pat Smith Fiona Ward Helen Bailey Mandy Doherty Shirley Woods Area Representative Choose N/A Hazel Balding Michelle Bassett Karen Brandon Kevin & Jane Bunce Alan & Margaret Clapham Karen Clayton Mr & Mrs Coulson Arlene Forman Julian & Rosemary Gostling Anne Green Jean Hahm Jane Hannah Alison Huckle Peter & Linda Humphreys Mr & Mrs Jeffries Rod Jones Alan Leightell Cath Marchbank Susan Meek Heather Payne Jacki Pilling Carol Rutherford Sandra Simpson Pat Smith Jim Talbot Janet & Bob Tolley Fiona Ward Jenny & Martin Watson Fiona Walton Mr & Mrs Waring Jean Hill Helen Bailey Kirsten Ritchie Nick Sanders Emma Logan Margaret Mabon Stephanie Godin Your email Dog information (optional) Date in Dog name Sex Male Female Age Date of birth Neutered Yes No Not known Chipped Yes No Not known Chip Number Aggression Choose 0 - No known aggression 1 - Exhibits minor aggressive tendencies 2 - Shown aggression to other animals or human 3 - Serious and repeated aggression Any other information Owner details (optional) Reason for handing in Owner Name Contact telephone Owner email Owner Address Send