I certify that the information I have
provided on this form is
true, correct,
and accurate. I am financially and
physically capable to care for the
animal that I adopt. I understand
and agree that the falsification
of
any
of the above information is
grounds to
disqualify my adoption
application and nullifies adoption
agreements. I understand that
there is no obligation to
adopt an
animal
to me, now or in the future.
I understand that my electrically
generated signature [below]
is valid as a means of legal signature
for the purpose of this
adoption application.
Signature/Date: