Spirit of St. Louis Pug Fanciers, Inc

This form must be used to adopt a rescue pug. Please answer all questions with the knowledge that Metro St.Louis Pug Rescue is committed to making each placement the most perfect possible. Please return the form to*:

 Metro St Louis Pug Rescue, Ken and Sue Thornberry
1747 Golden Lake
Chesterfield, MO 63017
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*Form may be emailed as a message, or as a Microsoft Word document or PDF attachment.

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Name:                                                                                                                                       

Address:                                                                                                                                  

City:                                                         State:                                     Zip:                         

Telephone:                                    Evenings:                                 Work:                            

E-Mail:                                                          Referred By:                                                   

Do you own or rent?                                 

Does your landlord allow pets?
(Please include a copy of lease or landlords phone # if applicable)

Number of years at current address:             Do you have a fenced yard?                  

Do you have a swimming pool?                   

Are you planning to move within the next six months?                                                  

How many people will live with the pug?                 Adults              Children:                

Names and Ages                                                                                                                     

Does everyone agree on owning a Pug?               Does anyone object to snores?          

Does anyone object to dog hair?                Would you object to a home visit?                

List all other animals in the home:                                                                                       

List all the animals you have had in the last five years and what happened to them:

What if the pug does not a get along with present animals?                                             

Name of Your Veterinarian:                                                                                                  

Address:                                                                         Phone:                                              

Will you keep the Pug in conditioned air indoors?                                                              

Will you use heartworm preventative?                                                                                

How long will you allow for an adjustment period?                                                            

How will you correct the Pug?                                                                                               

How will you confine the Pug?                                                                                               

How much time per day will the Pug be alone?                                                                   

Will you leash train the Pug?                                                                                                  

What will you do if the Pug is lost?                                                                                        

Do you realize that Pugs overheat easily?                                                                            

Is your home safe from poisons or other dangers a curious Pug can get into?               

How will you react if your Pug chews a personal item?                                                     

What eye care will your Pug have?                                                                                       

How much per year are you prepared to spend on your Pug's health care?                   

Do you realize that a Pug, like a child, is a lifelong commitment and not a passing whim?

Why do you want a Pug?                                                                                                         

LIST THREE PERSONAL REFERENCES AND TELEPHONE NUMBERS (NON-RELATED PREFERRED). All will be contacted.

1. Name:                                                          Telephone:                                                      

2. Name:                                                         Telephone:                                                       

3. Name:                                                          Telephone:                                                     
 

Name:                                                                                          Date:                                     

Signature:

Further comments you would like to make: