ADOPTION APPLICATION

Personal Information

First Name

Last Name

Work Phone

Home Phone

Address

City, State

Zip

E-mail

Occupation

Best time to contact you 

Living Arrangements

Own Rent Other

How long at current address

Does your lease or homeowners have any pet restrictions

 Yes

No 

Name of lease holder or landlord 

Address of lease holder or landlord 

Phone number of landlord 

Is your yard fenced

Do you have a pool 

 

 Yes  No

Yes  No

Do you plan to keep the dog indoors or out, please explain below


How will the animal be exercised, please explain below

 

How often do you travel

When nobody is home, where does your dog stay

                                            

 

Animal Preferences & General Breed Knowledge

If you interested in a pug on our website, please specify by name

 

Why do you want to adopt a pug, and what do you know about the breed, please explain

 

Are you willing to adopt a pug that would require daily medication  Yes  No 

In the case of an unforeseen circumstance that you would no longer be able to keep the dog do you understand and agree that the animal must be returned to Planet Pug Rescue    Yes     No

Do you have any problems or objections to allowing us to visit your home prior to adoption  Yes No

Have you ever applied with another rescue organization, If so, which organization  

 

Pet History

List All Pets You Currently Own

Dogs:

Breed

Age

Cats:

Breed

Age

Tell us why you would be the perfect forever home to a rescue pug

 

References

List 2 references that can attest to your responsibility as a pet owner.  If you own any pets now, please include your veterinarian as a reference.

Reference #1

Name

Street

City, State

Zip

Phone

Relation (if not your vet)

Reference #2

Name

Street

City, State

Zip

Phone

Relation  

I, attest that, to the best of my knowledge, the above information is accurate and complete. I understand that falsely provided information can mean that my application will not be considered.

Signature

Thank you for taking the time to complete this application.  It is our responsibility to ensure we place the right animal in the right family. Improper placement can end tragically, most often for the dog.

Planet Pug Rescue, Inc of Delray Beach, FL