Adoption Application

Welcome to Colorado Pug Rescue

A 501(c)(3) non-profit corporation dedicated to pug welfare

HOT LINE: 303-659-9689

APPLICATION FOR ADOPTION

Date submitted

Specific pug requested

Your Information

Full name
Address
City
State
Zip
Home phone
E-mail address

Your Employment Information

Occupation
Name of employer
Work phone #
How long there?

Spouse Employment Information

Occupation
Name of employer
Work phone #
How long there?

Pet History

Have you owned other pets before?

Yes No

If yes, list kinds and number of pets you have owned in the past 7 yrs.

If no, why do you want a pug now?

Do you still have the pets listed above?

Yes No

If not, what happened to them?

Are they spayed or neutered?

Yes No

If not spayed/neutered, why not?

About Pugs

Have you ever owned a pug before? Yes No	Why do you want a pug?
How have you educated yourself about the pug breed?
Please list your preference regarding... Sex of pug: male female either Color of pug: fawn black either	Preferred age of pug: minimum maximum
What, if anything, would you consider other than your stated preference (such as sex, color, age)?

Your Household

List names and ages of members of your household.
Do you own or rent your home? Own Rent	How long have you lived at your current address?
If renting, do you have your landlord's permission to keep pugs? Yes No	Can you provide us with such permission in writing? Yes No

Caring for the Pug

Where will you keep the pug?	During the day? During the night? During family absences overnight?
Do you have a fenced yard? Yes No	If yes, how large an area is fenced and with what kind of fencing? If you do not have a fenced yard, how will you exercise the pug, confine the pug, provide for his need to eliminate?
What is the maximum number of hours your pug will be left alone during a 24-hour period?	Where will he spend this time?
Do you object to the discriminate use of a cage or crate? Yes No	Do you have a crate? Yes No	Would you get a crate? Yes No
What will you do if your pug is destructive when left alone?
Are you willing to attend obedience classes with your pug? Yes No	Have you ever trained a pug before? Yes No
Have you ever surrendered a pet of yours to an animal shelter? Yes No	If yes, why?
Have you ever sold or given away one of your pets? Yes No	If yes, why?
Can you afford to spend at least $300 per year on food and routine medical care for your pet? Yes No

Miscellaneous

List your regular veterinarian with address and phone number.

May we visit your home and check your references to verify the information you have provided?
Yes          No
Is anyone in your household allergic to dogs?
Yes          No

What are the requirements for dog ownership in your community? How many pets may you legally have?

Are dogs required to be vaccinated against rabies?
Yes          No
How much time per day will you spend with your pug?

What do you plan to feed your pug? (Be specific, please.)

What circumstances, in your mind, justify getting rid of a pug?

Comments:

Thank you for taking the time to complete this application.
Falsification of any of the above information will be grounds to disallow your adoption of a rescued pug.
By submitting this form, I agree to the following application conditions.

I understand that sending this application does not automatically entitle me to a dog. I understand that this application is just a beginning step in the interview process.

I promise that I have read and understand all the information provided on the adoption page.

I understand that an adoption includes payment of an adoption donation which may range from $75 to $300 depending on the age and special needs of the dog (payable at the time of adoption).

I promise the information on this application is correct.

I agree to all the application conditions above.

Yes No

COLORADO PUG RESCUE RESERVES THE RIGHT TO REFUSE ANY ADOPTION.

If you have problems submitting this form online, please click the button below for a printable version.

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Send mail to the webmaster with questions or comments about the web site. Copyright © 2008 Colorado Pug Rescue Last modified: 02/26/08

Send mail to the webmaster with questions or comments about the web site.
Copyright © 2008 Colorado Pug Rescue
Last modified: 02/26/08