Pet Registration Form - Virginia

Rev. 4/04
Pet Registration Form
It is the policy of Pennsylvania Department of Agriculture and of Providence Forge Association that all animals be licensed and
vaccinated. In an effort to comply with state ordinances and to protect our animals, we have committed to achieving 100%
registration of our residents’ pets. Therefore, please complete the following form to register your pets with the Association.
Name of Owner(s) ____________________________________________Unit# __________ Phone# ________________________
Name of Tenant(s) (if rental) ___________________________________ Emergency Contact______________________________
Total number of pets at this residence? _______ Dog(s) _______ Cat(s)
In an effort to protect and identify those pets of Providence Forge, the Association will be providing identification tags (free of
charge) for all registered pets of our community. The registration will be valid for two years, and will be renewed on a bi-annual
basis. This tag will identify your pet as owned by a Providence Forge resident, and will be used to contact you in the event that your
animal is found.
PLEASE COMPLETE THE FOLLOWING FOR EACH PET IN YOUR HOME.
DOGS:
Name ________________________________________ Age _____ Breed _____________________________________________
M/F ___ Neutered/Spayed _______ Color/Markings _______________________________________________________________
License # ____________________ Rabies Vaccination Expiration Date ____________________Vet ________________________
Name ________________________________________ Age _____ Breed _____________________________________________
M/F ___ Neutered/Spayed _______ Color/Markings _______________________________________________________________
License # ____________________ Rabies Vaccination Expiration Date ____________________Vet ________________________
CATS:
Name ________________________________________ Age _____ Breed _____________________________________________
M/F ___ Neutered/Spayed _______ Color/Markings _______________________________________________________________
Rabies Vaccination Expiration Date _____________________ Vet ___________________________________________________
Name ________________________________________ Age _____ Breed _____________________________________________
M/F ___ Neutered/Spayed _______ Color/Markings _______________________________________________________________
Rabies Vaccination Expiration Date _____________________ Vet ___________________________________________________
In accordance with Pennsylvania Dog Laws, all dogs three (3) months of age or older must have a current license.
If you have not yet licensed your dogs with the county or one of its’ authorized agents, please contact the PF
Association Office at (610) 948-6714 to obtain a state license application. Licenses are issued by the County
Treasurer; they are good for a period of one calendar year, and must be renewed each January.
In accordance with Pennsylvania Rabies Vaccination Law, all dogs and cats three (3) months of age or older must
be vaccinated against rabies. Please see attached list of Montgomery County Health Department’s Rabies Clinics
that offer rabies vaccinations.
I have received and read a copy of the pet rules and regulations as stated in Section I, Paragraph C.2. of the Providence Forge
Homeowner's Association Handbook. I agree to abide by these and other pet rules to be promulgated in the future.
Signature of Pet Owner ________________________________________________________ Date _________________________
Witness ______________________________________________________ Date Received _______________________________
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