Pug Rescue San Diego Pug County Adoption Application
Pug Name(s)
First choice
Second choice
Your Name
First
Last
Spouse/Partner/Roommate
Name
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
Canada
Mexico
Other
Country
Home Phone
-
(###)
-
###
####
Work Phone
-
(###)
-
###
####
Cell Phone
-
(###)
-
###
####
Email
Best time to call
Which number
Pick a phone
Home
Work
Cell
Best number to call
Date to call
/
MM
/
DD
YYYY
Household Age Groups
Select age group
20-30
31-40
41-50
51-55
56-60
61-65
66-70
71-75
76+
Spouse/Partner Age Group
Select age group
20-30
31-40
41-50
51-55
56-60
61-65
66-70
71-75
76+
Your Age Group
Other adult(s) living at home
Other(s) Names
Age group(s)
Child(ren) living at home
Children(s) Names
Age group(s)
Does anyone in your house smoke indoors?
Yes
No
How does your Spouse/Partner feel about dogs?
Type of Work You Do
Description
Schedule
Spouse/Partner's Work
Description
Schedule
Does Either of Your Work Require Travel?
Yes
No
If Yes, Frequency and Duration of Trips
Where would the Pug stay when you go out of town?
Friend
Relative
House-sitter
Vet
Kennel
Other
Describe
Is someone home during the day?
Yes
No
Where will the Pug stay during the day?
How many hours a day will the Pug be left alone?
Length of time at This address
Are you moving within a year?
Yes
No
Do you rent or own your home?
Own
Rent
If renting, you MUST provide a statement from landlord stating his/her name & phone number, and any pet restrictions.
Where do you live?
House
Condo
Townhouse
Apartment
Mobile Home
RV Park
Do you have a Homeowner's Association?
No
Yes
If yes, you MUST provide CCRs with HOA name, phone number & pet restrictions for the complex.
Do you have an
enclosed
Front Yard
Back Yard
Describe your yard
Do you have an
enclosed
Pool
Spa
Pugs can't swim,
Describe:
Are you willing to reinforce enclosures if we deem it necessary to protect the Pug?
Yes
No
Will you stop using toxins (pesticides, snail bait, Weed & Feed, antifreez) in areas the Pug can get to?
Yes
No
Do you have a Gardener?
Yes
No
Do you have a house Cleaner?
Yes
No
What type of Pug do you wish to adopt? Be specific, so we can best match you to your Pug. (All PRSDC Pugs are neutered or spayed.)
Active
Mellow
Young
Adult
Senior
Male
Female
Special Needs
Black
Fawn
Any
Explain
What other pets do you have now? (include all species)
Breed
Age
Altered?
Inside/Outside
Time owned
Gender
Breed
Age
Altered?
Inside/Outside
Time owned
Gender
Breed
Age
Altered?
Inside/Outside
Time owned
Gender
Breed
Age
Altered?
Inside/Outside
Time owned
Gender
Are you allergic to any animals?
No
Yes
If Yes, Explain
Where, specifically, will the Pug sleep?
House
Garage
Outside
Laundry Room
Adopter's Bed
Child's Bed
Other
Explain
Can you deal with a snoring Pug?
Yes
No
Will the Pug be allowed on the furniture?
Yes
No
Will you deal with housebreaking?
Yes
No
Will you accept a special needs Pug?
Yes
No
Would you ever leave your Pug in a car?
Yes
No
Have you ever relinquished a pet?
Yes
No
Have you lost a pet within the last 5 years to:
Accident
Illness
Moved
Lost
Stolen
Euthanasia
Explain
If your pug has a housebreaking accident, you should:
Hit the dog and say, "NO!"
Put the dog's nose in it and say, "Bad dog!"
Lightly spank the dog and put it outside
Other
Explain
Do you agree to keep your Pug current on all shots?
Yes
No
Will you keep a current ID tag on your Pug at all times?
Yes
No
Do you intend to get your Pug micro-chipped?
Yes
No
Pugs, like any other pet, require a top quality diet and routine veterinary checkups as well as regular dental care. In addition to their annual shots and other routine exams, there is always the possibility of illness or emergency care and its accompanying expenses. Will you commit to this financial responsibility?
To adopt a Pug from Pug Rescue of San Diego County (PRSDC), adopters must have an extremely high level of commitment to their dog. It is a responsibility for the life of the dog, whether sick or well, young or elderly. The average life span of a Pug may be 12-15 years. Pugs are to be treated as family members throughout their lives. A volunteer from PRSDC may check back with you once or twice after the adoption. Should conditions ever be substantially different than the Adopter has represented, PRSDC reserves the right to reclaim the Pug if they feel it is in the Pug's best interest. Should an Adopter ever have to give up a Pug, unless prior arrangements have been made with PRSDC, ownership will automatically revert to, and the Pug must be returned to, PRSDC. ADOPTION FEES USUALLY RANGE FROM $100 - $800, DEPENDING ON AGE, HEALTH AND PERSONALITY OF THE PUG.
(Initial to confirm your understanding and agreement)
Personal reference
Name
Address
Phone
Your veterinarian
Name
Address
Phone
I have read and agree to the terms above:
Signature
Date
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