**WARNING!! DO NOT HIT YOUR 'ENTER' KEY WHILE FILLING OUT THIS APPLICATION! PLEASE JUST TAB BETWEEN FIELDS, OR USE YOUR MOUSE TO PROCEED TO THE NEXT BOX. ONCE THE ENTER KEY HAS BEEN PRESSED, THE APPLICATION WILL SUBMIT AND YOU WILL HAVE TO START ALL OVER AGAIN!

Date

Please provide the following contact information:

Name
Street Address
City
State
Zip Code
Cell Phone
Home Phone
E-mail

Number of Adults in household.

Number of children in household.

Ages of children in household. *Please Note: Because many of our Rescuepugs come from unknown backgrounds, we do not to adopt to families with children under 4. Please understand we are only trying to protect the little ones (pugs and children) from harm.*

Let us know what your work schedules are like. How many hours a day are you away from home for work/school etc?

How long have you lived in Nevada? We do not adopt outside of the Las Vegas, Nevada area. If you are not in Las Vegas, please see our Pug Rescue Links page for a Rescue in your area.

Type of dwelling.

house condo/townhome apartment other

Do you Own or Rent?

Own Rent

If renting: Do you have landlord approval to have a pet?

yes no N/A

If renting: Name and phone number of landlord/rental agency.

Do you have a fenced yard?

yes no

Do you have a swimming pool?

yes no

Does the swimming pool have a safety fence?

yes no N/A

Do you have a doggie door?

yes no Would install one if adopting

Number of dogs in household

0 1 2 3 4+

Number of cats in household

0 1 2 3 4+

Are all cats declawed?

yes no N/A

List ages and breeds of pets in household. Please tell us a bit about their personalities (Is Pugsly a couch potato, Is Mugsy a Tazmanian devil?) This will help us make a match when considering your application. 

Are all of your pets spayed or neutered?

yes no N/A

Where do your dogs stay while you are away from home?

In the yard
In a crate
In the garage
In the house confined to an area
In an outdoor run/pen
In the house not confined to an area

Where will the dog sleep?

Name and Phone number of Vet. We will check with your Vet for Veterinary history, as well as spay/neuter status of all household pets. If you are new to the area, and do not have a Vet in Las Vegas, please include a Vet reference from your former city. Applications without a Vet reference will be discarded.

List any pets you have previously owned: (If deceased, cause of death)

If you are applying to adopt a specific Pug from our "Adopt Me" page, please name here.

Age of Rescue Pug wanted. You can choose more than one option.

2-5 years
6 years and older
age does not matter

Do you have a color preference? 

fawn black No Preference

Do you have a gender preference? We get many more male Pugs than female Pugs through our Rescue. If you select "female", please keep in mind that the wait may be much longer. 

male female No Preference

Would you consider a Pug Mix?

yes no maybe

Would you consider a Special Needs Pug?

yes no maybe/not sure

If yes, what type of Special Needs would you consider?

Vision problems
Hearing problems
Medical needs

What type of Pug Personality would best fit your household?

playful
quiet
outgoing
sedate

Have you ever had a Pug?

Yes, I have a Pug now
Yes, in the past
No

If not, have you researched the breed?

yes no

Why do you want to adopt a Rescue Pug?

Have you ever had to give a dog up? If yes, please explain the circumstances.

Rescue Pugs often have housetraining problems when adjusting to their new home. How would you deal with this?

Please provide any additional information that would be helpful in considering your application for adoption. We will keep your application on file for six months. If several months have passed and you have not heard from us, please e-mail and let us know you are still interested!

All dogs are spayed/neutered, current on all vaccinations, and Vet checked prior to adoption.

Adoption Fees:

Pug puppies under 1 year old: $300

Pugs 1 to 5 years: $250

Pugs 6-7 years: $175

Pugs 8 years and up: $100

 ***By submitting this application for adoption, the applicant agrees to a home visit prior to adoption and a a Vet records inquiry.***