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Name:
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Street Address:
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City, State, Zip
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Home Telephone:
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Cell:
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Email:
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Best time to call:
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Please provide the
names and ages of all
children living in your
home.
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Please list the ages of
any other children who
visit frequently.
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Please provide the
names, ages, and
relationship of any
other members of
your household.
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Please list all other
pets in your household
including breed, age,
and gender.
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Have you owned a dog
before? Please provide
details including breed
and gender.
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Have you owned a pug
before? Please provide
details.
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Do you have a fenced in
yard? If so, what type of
fence and how large is the
fenced in area?
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Who will be home with
your pug during the day?
If you work how much time
will the pugs spend alone
each day?
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What gender pug do you
want to adopt?
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What color pug do you
want to adopt?
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Up to what age are you
willing to adopt? You may
choose more than one
selection.
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Would you consider
adopting a special needs
pug?
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Would you be interested in
adopting more than one pug
at at time?
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Do you rent or own your
home? If you rent you will be
required to provide a letter
from your landlord stating
you are allowed to have a
dog.
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How long have you lived at
your present address?
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Are you planning to move
within the next 6 months?
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Does your home have any of
the following? Please check
all that apply.
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Where will your pug sleep at
night?
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Where will you keep your pug
when you are not at home?
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Will you keep your pug
indoors at all times unless
you are outside with him?
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Does everyone in your home
agree to adopting a pug?
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Does anyone in your home
suffer from allergies? If yes,
please provide details.
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How will you react if your pug
behaves inappropriately such
as chewing, inappropriate
barking, or going to the
bathroom in the house?
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What will you do if your new
pug does not get along with
your other pets?
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How long of an adjustment
period will you allow?
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Are you prepared to spend
money on your Pug's health
care?
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Do you realize that owning a
pug is a lifelong commitment
and that your pug may be
costly over the course of its
life?
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Is there any other information
that might influence PRoNE's
decision to adopt a Pug to
you?
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Please provide the name,
address, and telephone
number of our vet.
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Please provide the name, relationship, and
telephone number of 3 personal references.
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Reference #1
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Reference #2
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Reference #1
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