PRSDC Pug Application

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

Country
Home Phone - (###) - ### ####
Work Phone - (###) - ### ####
Cell Phone - (###) - ### ####
Email
Best time to call
Which number
Best number to call
Date to call / MM / DD YYYY
Household Age Groups
Spouse/Partner Age Group

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 - $400, 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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