We are a 501(c)(3) organization dedicated to our dogs

Applying for Adoption
BEFORE PROCEEDING TO THE ADOPTION APPLICATION, PLEASE READ THE FOLLOWING:

Adoptions fees must be paid by bank check or cash. Personal checks are not accepted. Sorry, no exceptions.

Adoption donations are, without exception, NON-REFUNDABLE.

Read the Adoption Contract you are required to sign before you apply to adopt.

WE CHECK VET REFERENCES! If your current or previous pets are not altered or have not been kept up-to-date on shots, heartworm prevention and well-care, this application will be discarded.

 

We need to know as much about you as possible before we consider allowing you to adopt one of our rescues. The information you provide on our application/contract will help us determine the best possible match for you, as well as for the dog. Please answer all questions honestly, as there are no right or wrong answers.

Pekes and Pals relies on your donations to care for all the homeless dogs in our care. This donation helps defray the costs of veterinary care given to your dog prior to adoption. This care includes, but may not be limited to, all vaccinations, heartworm testing and prevention medication, flea prevention, fecal testing and worming if necessary and surgical procedure for spay/neuter. Your adoption donation also helps to feed, house and provide veterinary care for the dogs still waiting to be adopted, and is NON-REFUNDABLE. You are not buying a dog, you're making a donation. Out-of-state adoptions are acceptable but we do not ship our companion dogs and adopting families must come to Pekes and Pals to complete the adoption. Sorry, no exceptions.

Pekes and Pals Canine Rescue Adoption Application

* ALL BLANKS MUST BE FILLED IN

If a question does not apply to you, fill in the blank with "N/A"

* 1. Name of dog desired:
* 2. Applicant's full name:
* 3. Co-applicant's full name:
* 4. E-mail address: (Please double-check this)
* 5. Address:
* 6. City:
* 7. State:
* 8. Zip Code:
* 9. Daytime phone no: (xxxxxxxxxx)
* 10. Evening phone no: (xxxxxxxxxx)
* 11. Applicant's age: * 12. Co-applicant's age:
* 13. Why do you want a dog at this time?

* 14. Why do you want this breed?

* 15. Weight of dog wanted:
* 16. Would you consider a special needs dog? Y/N/M:
* 17. Would you consider a dog that is not housebroken? Y/N/M:
* 18. What are your thoughts on the use of crate training for your dog?

* 19. Applicant's occupation:
* 20. Co-applicant's occupation:
* 21. Applicant's place of employment and phone no.:
* 22. Co-applicant's place of employment and phone no.:
* 23. Please specify what type of home you live in: Type
S for Single Family, M for Mobile Home, D for Duplex, C for Condo, T for Townhouse, O for Other: S/M/D/C/T/O:
* 24. Do you rent or own? Type R for Rent, O for Own: R/O:
* 25. If you rent, please provide the name and telephone number of your landlord:

* 26. How long have you lived at this address?
* 27. How long at your previous address?
* 28. Please list all people currently living at this residence, their relationship to the applicant and their ages:

* 29. Do you have a pool or hot tub? Y/N:
* 30. If you do, is it fenced/covered so that a pet CANNOT get to it? Y/N:
Explain, if necessary.
* 31. Home visits are required by rescue. Is this acceptable to you? Y/N:
* 32. Days and times you are available:
* 33. If you work, is anyone at home while you are working? Y/N:
* 34. Will this person be responsible for the dog? Y/N
:
* 35. Do you have a completely fenced area on your property? Y/N:
If No, please tell us how you will address the dog's exercise and bathroom needs, etc.

* 36. How many hours each day will your dog be alone? Weekdays:
36. How many hours each day will your dog be alone? Weekends: 36. How many hours each day will your dog be alone? Evenings:
* 37. Where will your dog be kept during the day (loose indoors, crate, basement, laundry room, kitchen, other confined room, fenced yard, chained outside, dog run, outside kennel run, on lead attached outside, loose outdoors, garage, dog house, etc.)? Please be specific!

* 38. Where will the dog sleep at night? Again, be specific.
* 39. Who will be responsible for feeding the dog?
* 40. Who will be responsible for housebreaking the dog?
* 41. How much experience does this person have in housebreaking and training a dog? Explain.

* 42. How would you handle housetraining? Explain.

* 43. Who will care for the dog in the event you are ill on vacation or otherwise incapacitated?
* 44. Have you, as an ADULT, owned a dog before? Y/N:
If the dog is no longer with you, please provide a brief explanation of where it is now.

* 45. Have you ever had an animal die at an early age? Y/N:
If yes, please explain.

* 46. Have you ever given an animal to another person, rescue or shelter? Y/N:
If yes, please explain.

* 47. Please list below any pets who currently live in your house. Include their name, breed, sex, age, years owned and whether or not they are spayed or neutered.

* 48. Are these pets up to date on shots, heartworm preventative, veterinary care, etc.? Y/N:

If not, please specify which ones and why not.

VET REFERENCE: WE REQUIRE THAT YOU PROVIDE THE NAME OF YOUR CURRENT VET, OR IF YOU HAVE NO ANIMALS AT THIS TIME, THE NAME OF A VET YOU HAVE USED IN THE RECENT PAST. WE WILL CALL THIS VET TO CHECK ON YOUR PREVIOUS CARE OF ANIMALS.
* 49. Name of vet's office:
* 50. Vet's phone number:
* 51. Vet's full address including state and zipcode:
* 52. Approximate date of last visit:
* 53. Reason for last visit:
* 54. What name are vet records listed under?
* 55. Groomer reference: If you have a groomer you have used before, please list the name and phone number here:

* 56. *Personal Reference 1 Name and phone number (not family members):

* 57. *Personal Reference 2 Name and phone number (not family members):
* 58. *Personal Reference 3 Name and phone number (not family members):
* 59. How did you hear about Pekes and Pals?:

* 60. Would you be willing to volunteer some time to help us with Rescue? Y/N:
* 61. Would you be willing to volunteer some time to help us with Foster Care? Y/N:
* 62. Would you be willing to volunteer some time to help us with Transportation? Y/N:
* 63. Would you be willing to volunteer some time to help us with Home Visits? Y N:

These donations are necessary to help offset the expense of caring for these dogs until we find them new homes. Your donation is tax deductible to the extent the law allows.

 

 

GoodSearch: You Search...We Give!

A copy of the official registration (#CH15616) and financial information may be obtained from the Division of Consumer Services by calling (800) 435-7352, toll-free within the State. Registration does not imply endorsement, approval, or recommendations by the State.

This site is donated by our Webmasters. Copyright 2003-2011. The entire content of this site is the property of Pekes and Pals Canine Rescue, Inc., including photos, descriptions and graphics, and may not be used without written permission.

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