Registration Form Completion (Section 6 of 6)

(please take a moment to answer all items)

K9 Korral reserves the right to reject any application for adoption. Applicant, by signing below, gives permission for a representative of K9 Korral to contact references and landlord (if applicable) provided on this form, and make a home visit prior to adoption. Applicant further acknowledges that all information contained in this application is true and correct, and that any misrepresentation may result in the removal of the adopted pet if adoption is approved. Applicant understands there is and adoption fee due at the time of adoption.

mm/dd/yyyy