Adoption Application

We focus on finding good matches between pugs and families to ensure lifelong adoptions. Seattle Pug Rescue reserves the right to refuse adoption to anyone without disclosing the reasons.

Please complete the following form if you are interested in adopting a rescue pug.

Fields marked with an * are required.



Contact Information


xxx-xxx-xxxx
xxx-xxx-xxxx
8 am - noon
Noon - 5 pm
Evening

Home Interview Availability


Yes No


Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday


8 am - noon
Noon - 5 pm
Evening

References

We may also call references and/or your veterinarian as part of the interview. Please provide three references (not related) and their telephone numbers.

Veterinarian

Yes
No
xxx-xxx-xxxx

Note: Please give your veterinarian consent to release medical records and information to Seattle Pug Rescue, so as not to delay the processing of your application.

Rescue Pug Preferences


Purebred
Pug Mix
Either


Male
Female
Either


Fawn
Black
Either


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


Yes
No
Maybe


Yes
No
Maybe

Pug Living Conditions


hours

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

Pug Knowledge


Yes
No



Home Details


House
Apartment
Condo
Mobile home/trailer
Other,


years


Own
Rent


Yes
No


Yes
No


xxx-xxx-xxxx


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




Household Occupants









Yes
No


Yes
No


Yes
No
Possibly

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 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.