Projets

First name* :

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Backup first name :

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Work email :

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Your work address (street and number)* :

Workplace postal code* :

Workplace city / town* :

Workplace country* :

Your street and number* :

Postal code* :

City / Town* :

Country* :

Email* :

Phone / Mobile :

Contact person* :

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What sector do you work in?* :

You live in a :

Apartment without garden Apartment with garden House without garden House with garden

Do you have other animals at home? :

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If yes, which ones? :

What tasks will be required of the dog? :

What are your daily and regular routines? What might your dog be exposed to?* :

How did you hear about Os'mose?* :

Do you authorize Os'mose to collect your data? :

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