**The legal name and date of birth is required for all adults (18 and older) residing in the home.
Where will your pet be kept? (check all that apply)
By signing below, I certify that the information I have given is true and I recognize that any misrepresentation of the facts may result in my losing the privilege of adopting a pet. I authorize investigation of all statements on this application. Verification of vetting, landlord and available public records will be checked for accuracy of information. I understand that this application is property of the JR’s Pups-n-Stuff.