Adoption Application

We focus on finding good matches between pugs and families to ensure lifelong adoptions. We only consider serious applicants and require a non-refundable adoption application fee to be paid along with your application ($12.50). We adopt to residents of Washington and bordering states, as well as British Columbia and Alaska.

You must be at least 21 years old to adopt. This application is to assist in screening for suitable placement of Seattle Pug Rescue dogs. SPR may refuse placement of a dog for any reason. When submitting this application you give permission for SPR to examine and verify the information that you provide. We will also do a home check or phone interview, in addition to calling your references and veterinarian. All forms are property of SPR. Thank you!

Fields marked with an * are required.


Personal Information


xxx-xxx-xxxx
xxx-xxx-xxxx




References

Please list 2 personal references not living at your address and who are not related to you. Provide name, address, telephone number and email.

If you have a vet, please provide the following information. Note: Give your veterinarian consent to release medical records and information to Seattle Pug Rescue, so as not to delay the processing of your application.

xxx-xxx-xxxx

Home Details



House
Apartment
Condo
Mobile home/trailer
Other,


years


Own
Rent


Yes
No


xxx-xxx-xxxx


Yes
No



Yes, fully fenced
Yes, partially fenced
No
N/A


hours


Yes
No

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

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


Adoption


Yes
No


Yes
No


Yes
No


Male
Female
Either


Fawn
Black
Either


Puppy
1-3 years
3-6 years
6-10 years
10+ years


Yes
No
Maybe


Yes
No
Maybe


Yes
No




Additional




Yes No


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 adopt 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 18 years old OR that if I am under 18 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 interview.

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.

Copyright 2005-2011 Seattle Pug Rescue. All rights reserved. Seattle Pug Rescue is a 501(c)(3) nonprofit organization.