No Chihuahua Wants to be Alone Rescue Group

Please Note:
*Homes in which there are children under 10 years of age.
You must bring your children to our home,So we may see how your child interacts with pets.
* Our dogs are not adopted out to homes outside of the Continental United States.

Application for Adoption

Name(s): ________________________________________________________
Address: ________________________________________________________
City: _____________________________ State: ___________________ Zip: _________________
Phone (Home): __________________________Phone (Work): _______________________________
Best Time to Call: Morning, Afternoon, Evening
Email Address: ____________________________________________________________________
1. Why do you want to adopt a dog? ________________________________________________________________
2. What do you think are the most important responsibilities of owning a dog?
________________________________________________________________________________
3. For whom are you adopting the dog? _____________________________________________________________
4. Does everyone in your household know that you are applying for a dog, and does every member of your household want a dog? Yes, NO
please explain_____________________________________________________________________________________
5. Have you ever owned a pet before? Yes No

6. Please describe those pets that are currently with you (type, age, sex, altered status):
________________________________________________________________________________
________________________________________________________________________________
7. Please describe those pets that are no longer with you (type, sex, etc.):
________________________________________________________________________________
________________________________________________________________________________
8. Why are the pets no longer with you?
________________________________________________________________________________
________________________________________________________________________________
9. Does anyone in the household have allergies? Yes, No

10. How many people reside in your household?
Name & age of each:
________________________________________________________________________________
________________________________________________________________________________
11. Are there any children under the age of ten residing with you or frequent visitors?? Yes, No
If yes, what are the ages?
________________________________________________________________________________
12. Please provide the name, address, and phone number of the veterinarian for your pets.
(If you've had pets in the past, please list the info for the vet that cared for your past pets.)
________________________________________________________________________________
________________________________________________________________________________
(If you do not currently have a pet, please provide the information about the vet that you will be using if you adopt a dog.)
________________________________________________________________________________
________________________________________________________________________________
13. Who will be responsible for feeding, housebreaking / training?
________________________________________________________________________________
14. Do you own or rent your residence? Own, Rent
15. If you rent, please provide the name, address, and phone number of your landlord.
________________________________________________________________________________
Please note that if you live in a condo, assisted-care facility, or senior housing, we will need a letter from management stating you may adopt a dog from us.
16. What type of home do you live in? (Condo, single-family dwelling, apartment, etc.?)________________________________________________________
17. Where will the dog stay during the day? Loose, Indoors, Crate, Basement, Outdoors Loose, Fenced yard, Tied up outdoors, Kennel run
18. How much time wills the dog spend outside?______________________________________________________________
19. Will anyone be home during the day? (If so, who?__________________________________________________________
20. How frequently will the adults be gone away from home on business/ vacation/trips? _____________________________
21. When you are on vacation, where will the dog be kept?
Home, someone comes over to feed, Pet sitting service, Will board dog at kennel or Vets, Other
(please specify)_______________________________________________________________________________
22. Where will the dog sleep every night? ________________________________________________________________
23. What do you intend to feed the dog? ______________________________________________________________
24. Most of our dogs are housebroken/crate trained/puppy pad trained,although in some cases the animals
may have been sick and may need to be re-trained, are you willing to housebreak a dog. (Details please)?
_______________________________________________________________________________
25. How many hours a day will the dog be left unattended? _________________________________________
26. Please list any preference you have in adopting a dog (age, sex, personality).
If you have seen a dog at our web site that interests you, this would be the place to include that dog's name.
_______________________________________________________________________________
Please circle the following which best describes which your interested in-
0 to 5 years, 5 to 10 years, 10 years and older (most Chihuahuas live to 20 years of age.)
Special needs or Handicap dogs ---Male, Female, and No Preference
Please note: if you are looking for an un-altered pet, we will not be able to place a Chihuahua with you.
All Chihuahuas placed by us are altered prior to placement!!!
Long or Short coat, Color of coat? ______________________________________
Please list any other specifics that would help us locate a Chihuahua for you:
_______________________________________________________________________________
27. How many dogs have you owned in the past 10 years? _______________________________________
28. Have you ever owned a Chihuahua before? ________________________________________________________
29. What made you choose a Chihuahua?
_______________________________________________________________________________
30. Will you keep the dog licensed, and have an ID (other than the license) on the dog at all times?
Yes, No ________________________________________________________________________
31. Would you contact us if you can no longer keep the dog you adopt? Yes, No

32. Will you allow one of our representatives to visit your home? Yes, No If not, why?
_______________________________________________________________________________
33. Do you understand that an adoption fee is requested for each Chihuahua? Yes, No
Please note: The adoption fee is $200.00 per dog (not including transport cost).
This Fee helps defray the veterinary costs incurred for spay/neuter, immunizations,
heartworm testing and prevention, and other medical needs required by every Chihuahua we place.
35. Where did you hear about us? (Please be specific.)
Internet, Shelter, Newspaper, Flyer, Friend Other (Please explain): ______________________________
Reference-
Name:_____________________________________________
Address:_____________________________________________
Phone:______________________________________
I represent that the information that I have provided on this form is the truth to the best of my knowledge and belief,
and hereby give my permission for you to use any of the above information to confirm that all information provided is the true.
This means you give us your permission to call references, and that you allow us to contact your vet,
and that you hereby give consent for your Vet to release the information in your current/past pets' health files to us.
Sign-_____________________________________________Date-____________________
DO NOT BE DISCOURAGED-
When several people are interested in the same dog, the foster home reviews their application,
exchanges e-mail with them, and reviews their home visit report.
The foster home then selects which applicant has the best environment and lifestyle for the needs and personality of the
foster dog, since not every approved home is right for every dog. WE ARE LOOKING FOR THE RIGHT DOG FOR YOU.