Adoption Form – Dogs

(if rural, list both physical & mailing address)
(example: calm, housetrained, athletic, affectionate, good with cats/kids/dogs, etc.)
(Dogs, Cats, Other)
(Dogs, Cats, Other)

Reference 1

*Only 1 reference can be a relative & that relative must not live with you. All references must be 18 years of age or older.*

**If references do not call back within 72 business hours after initial contact we will move on to the next applicant.**

Reference 2


Landlord (if applicable)

I certify that the information given on this form is true and correct and I recognize that any misrepresentation of facts will
result in my being unable to adopt a pet from PVHS. I understand that submission of this application does not guarantee
adoption and that approval or denial of this application is at the sole discretion of PVHS.