Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.This form is used to add someone to the Do Not Adopt List. Please submit one form per person! Provide information about the do not adopt (DNA) person being added to the list:First Name *Last Name *Email Address (if known)Mailing Address (if unknown, add as much as you do know!)Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCheckboxesMailing address and physical address are differentPhysical Address (if unknown, add as much as you do know!)Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone NumberReason being added to DNAThis information is shared on the DNA list with other local animal organizations.Please provide your information:Used to confirm you have authority to add people to the DNA list.Your First Name *Your Last Name *Your Organization *Email *Any other information you wish to share with HAVA(This information isn't shared on the DNA report)Submit
