Adoption Application
Questions marked by * are required.
1. We consider all serious applicants. PLEASE NOTE: WE ADOPT ONLY TO RESIDENTS OF TEXAS AND BORDERING STATES (New Mexico, Oklahoma, Arkansas, Louisiana). Are you a resident of one of these states? *
2. Are you at least 21 years old? You must be at least 21 years old to adopt. This application is to assist in screening for suitable placement of DFW Pug Rescue dogs. DFWPRC may refuse placement of a dog for any reason. When submitting this application you give permission for DFWPRC to examine and verify the information that you provide. All forms are property of DFW Pug Rescue. Thank you! *
3. Your Name (first and last): *
4. Address: Number & Street (not P.O.Box);If apartment, include apt. number, name of apartment complex. *
5. City *
6. State *
7. Zipcode *
8. Home Phone, Work and Cell phone and best days & times to reach you. *
9. Email address: *
10. Number of pets you own, or pets that live in your home. Please list breed, male/female, ages - are they spayed/neutered? If No, why? *
11. Do you live in a house, apartment or other? (PLEASE SPECIFY.) Does it have a fenced yard? Do you have a swimming pool? *
12. If leasing/renting, how many pets are you allowed to have according to the Lease Agreement? *
13. Name of your veterinarian/clinic, and complete address where your pet(s) records can be verified *
14. Phone number for your Veterinarian/clinic *
15. Emergency contact (other than yourself) - name, phone number and email address. (Relationship to you, i.e.,friend,relative,?) *
16. Would you be interested in a pug mix? (Yes or No) *
17. Would you be interested in adopting a senior pug (age 8 and over) or a special needs pug? The adoption fee is reduced and is based on the age of the pug and/or the medical needs of the pug *
  • Yes
  • No
  • Maybe- need to talk with an adoption counselor.
18. Do you have an active adoption application with any other rescue organizations at this time? If yes, who? *
19. Have you ever turned in an animal to a shelter? If yes, what were the circumstances?
20. DFW Pug Rescue does not "ship" pugs. Are you willing to travel to the Dallas, Ft. Worth, Texas area to pick up your pug? *
21. What arrangements will you make for your Pug(s) if you travel and do not take them with you? (Example: family, friend, boarding, pet sitter) *
22. Will you keep your pug on heartworm preventative? Yes/No *
23. Why do you want to adopt a pug? What do you know about pugs?
24. Do all family members favor a pug coming into the household? If there are children living in your home, what are their ages? *
25. Are you aware that pugs are FULL-TIME INDOOR DOGS and will you be able to accommodate your pug in this manner? Where will your pug spend most of its day? *
26. Please list 2 personal references NOT living at your residence and who are NOT related to you. Name, Address, Phone number, email address. *
27. Have you ever been convicted of a crime (misdemeanor or felony) other than a minor traffic violation? *
  • Yes
  • No
28. Any additional information you may want to provide.
29. Are you aware that pugs shed a lot? And snore? *
30. What is your occupation? *
31. How many hours will your pug be left alone during the day? *
32. Some pugs have special medical needs (i.e., eye problems, skin allergies). Are you financially able to provide any needed medical care for your pug? *
33. Are you interested in Male, Female or Either? *
34. Have you seen a pug(s) on our website or Facebook page that you are interested in? If so, which one(s)? PLEASE NOTE: There is no guarantee that a pug(s) you are interested in will still be available at the time that your Application is approved to adopt. *
35. Desired Age Range: (If you desire a very young pug (under 1 year of age), please note that we seldom rescue puppies, and the wait could be long.) *
36. To help DFWPRC make everyone aware of our organization, would you tell us how you heard about us?
  • Family
  • Friend
  • Event or Event Flyer
  • Adoption Event
  • Search on Internet
  • TV, Radio, Newspaper
  • Facebook
  • Blog
  • Twitter
  • Petfinder
  • Adopt-A-Pet
  • I am a previous DFW Pug Rescue adopter
  • Other
37. By Submitting this Adoption Application I affirm that all information is true and correct. *
  • Yes
  • No