Pugs N Roses Adoption Application
Full Name *
Occupation *
Home Street Address *
City *
How Long at this Address *
Phone Number *
Email *
How Many Adults in your family (their relationship to you) *
How many children in your family (ages) *
What type of home do you live in (apartment, condo, single family home) *
Please Describe your household *
Does anyone in the family have a known allergy to dogs? *
Is everyone in agreement to adopt the dog *
Do you have time for the dog? *
What other pets do you have (specify type and number)? *
Are these pets up to date on vaccines? *
Are these pets spayed/neutered? If not..why? *
Have you every surrendered a pet? If so, why? *
Have you ever had a pet euthanized? If so, why? *
Have you ever lost a pet to an accident? *
How do you discipline your pets and why? *
Do you have a regular veterinarian? *
Veterinarian’s name:
Clinic Name:
Clinic Address:
Clinic Phone:
Which Dog are you interested in adopting *
Where will the dog spend the day? (describe) *
Where will the dog spend the night? (describe) *
Number of hours (average) dog will spend alone? *
Do you agree to provide regular health care by a Licensed Veterinarian? *
Do you agree to keep the dog as an indoor dog? *
When the dog goes out, how do you plan to supervise it? Fenced yard?
Do you agree to contact Pugs N Roses if you can no longer keep this dog? *
Would you be interested in fostering? *
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