Please provide 2 references (Friend, Relative or other)
NOT LIVING WITH YOU

List the pets you own or live with now and for the past 7 years:

I certify that the information given by me in this application is true and complete.  I further understand that falsified information that I give will terminate action of the adoption process.  I hereby authorize release disclosure of records and or other information concerning all of the above inquiries, including but not limited to tenancy information and veterinary records. IF SUBMITTING ELECTRONICALLY I MAKE THE ABOVE CERTIFICATION AS IF SIGNED PERSONALLY.  IN ADDITION I CERTIFY THAT I AM AT LEAST 18 YEARS OF AGE.