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Dog out Leave this field blank Coordinator Details (optional) Welfare Co-ordinator Choose Liz Bradley Karen Clayton Shirley Evans Penny Gutridge Karl Hahm Tony and Caroline Hart Jean Hill Linda Kennerley Margaret Mabon Cath Marchbank Sarah Masters Rob McLeod Nick Sanders Gill Paul Simms Magda Teale Pat Smith Fiona Ward Helen Bailey Kirsten Ritchie 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 Jaqueline & Bernie Greef Anne Green Jean Hahm Jane Hannah Alison Huckle Peter & Linda Humphreys Mr & Mrs Jeffries Rod Jones Alan Leightell Cath Marchbank Sheila Maw Susan Meek Chris & Ann Mills Heather Payne Jacki Pilling Isla Reid Carol Rutherford Sandra Simpson Pat Smith Jim Talbot Janet & Bob Tolley Fiona Ward Jenny & Martin Watson Fiona Walton Mr & Mrs Waring Mr & Mrs Wells Jean Hill Helen Bailey Kirsten Ritchie Nick Sanders Your email Dog information (optional) Date out 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 Adoptee Details (optional) Adoptee Name Adoptee Telephone Adoptee Email Adoptee Address Donation Minimum donations are: (optional) Less than 1 year - £400 1.1 to 2 years - £300 2.1 to 5 years - £250 5.1 - 8 years - £200 8.1 - 10 years - £150 10+ years - £Nil Send