Miss Tasha Keeshond Rescue of North America Augie
Adoption Contact


Please give us a little information about yourself and your household.
We will locate the closest KRNA member, give them this information, and have them contact you.

Please note the fields in red and with an asterisk (*) are required.

*Name:
*Address 1:
Address 2:
*City/Town:
*State/Province:
*Zip/Postal code:
Telephone number (with area code):
*Email address:
Number of adults in the household:
Number of children in the household:
Age of the youngest child:
Age of the oldest child:
Current pets:
Dogs: Cats: Other:
Are you working, or have you worked, with animal rescue groups: Yes No
*Reason for adoption:
Any additional comments:

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