Adoption Application

Please complete the following form if you are interested in fostering rescue pugs. If you are unable to submit your application electronically, please use the printed application (PDF) and mail it to the address on the form.

Fields marked with an * are required.

Contact Information

First name*
Last name*
Address*
City*
State*
ZIP code*
Email*
Confirm email*
Home phone*	xxx-xxx-xxxx
Cell or alt. phone	xxx-xxx-xxxx
Best time to call*	8 am - noon Noon - 5 pm Evening

Home Check Availability

Seattle Pug Rescue requires a home check to be done on prospective foster homes. Will you agree to this?*
Yes No

Best day(s) of week for a home check*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Best time(s) of day for a home check*
8 am - noon
Noon - 5 pm
Evening

Rescue Pug Preferences

Type of pug desired*
Purebred
Pug Mix
Either

Sex*
Male
Female
Either

Color*
Fawn
Black
Either

Age*
6 months - 1 year
1-3 years
3-6 years
6-10 years
10+ years

Are you willing to adopt a pug with some medical conditions?*
Yes
No
Maybe

Would you be interested in becoming a Helping Hands home?*
Yes
No
Maybe

Pug Living Conditions

How many hours per day will the pug be left home alone?*
hours

Where will the pug spend its day?*

Loose indoors	Fenced yard
Crate indoors	Basement
Garage	Outdoor kennel
Tied up outside	Other

If "other," please describe

Where will the pug spend its nights?*

Loose indoors	Fenced yard
Crate indoors	Basement
Garage	Outdoor kennel
Tied up outside	Other

If "other," please describe

Pug Knowledge

Have you researched the pug breed?*
Yes
No

What are some of the pros of the pug breed?*

What are some of the cons of the pug breed?*

What are some of the common ailments of the pug breed?*

Veterinarian

Do you have a vet?*	Yes No
Vet's name
Vet's phone	xxx-xxx-xxxx
Clinic name

Home Details

What type of home do you live in?*
House
Apartment
Condo
Mobile home/trailer
Other, describe

How long have you lived there?*
years

Do you own or rent your home?*
Own
Rent

If you live in a condo, does the homeowners association permit dogs?
Yes
No

If you live in an apartment, do you have the landlord's permission for a dog?
Yes
No

Landlord's name
Landlord's phone xxx-xxx-xxxx

Do you have a fenced yard?*
Yes, fully fenced
Yes, partially fenced
No
N/A

How will you manage the pug's exercise and bathroom breaks?*

Household Occupants

How many adults live in your home?*

List all other dogs already in your household, including breed, age, sex and whether spayed or neutered

List all other pets in your household (cats, birds, reptiles, rodents, etc.)

List all children living in your home, including age and sex

Are any family members allergic to dogs?*
Yes
No

Do all family members wish to adopt a pug?*
Yes
No

Do you plan on moving or making any career changes soon?*
Yes
No
Possibly

Optional

Tell us why you are interested in a pug, research you've done, experience you have with the breed, and why you should be considered:

AGREEMENT

•	All of the information I have provided on this form is true and complete.
•	I have read and agree with the Seattle Pug Rescue Adoption Contract.
•	I agree that any dog I adopt from Seattle Pug Rescue will reside with me in my home as a pet. I will provide it with adequate food, water, shelter, training, affection and medical care.
•	I understand that Seattle Pug Rescue is a referral service and is not responsible for the accuracy or completeness of the information received about temperament, habits, or medical condition of dogs available for adoption.
•	I agree that is my duty to see and evaluate a dog for myself before agreeing to foster it.
•	Seattle Pug Rescue is in no way liable or responsible for any damage, accident or injury resulting from placement of a dog into my household.
•	I certify that I am at least 21 years old OR that if I am under 21 years old that I will inform Seattle Pug Rescue and that my parent or legal guardian approves this application and will be present at my home check.

Please enter your full, legal name here to indicate your agreement with the above statements:*

Note: We reserve the right to refuse any applicant.

Seattle Pug Rescue is a 501(c)(3) nonprofit organization.
Donations are tax-deductible to the extent allowed by law.