Pomeranian
Rescue Group Dog Adoption Application
Which dog/s are you interested
in?
Why do you want this
particular dog?
Name of Applicant (First &
Last):
Name of Spouse or Significant Other:
If this relationship were to
change, who would keep the pet?
If you have children, what are
their ages?
Please list any additional
people in the household?
Address: City: Zip:
Home Phone (include area
code):
Cell Phone (include area
code):
Work Phone (including area
code):
Email:
Occupation: Employer:
Do you live in a? House Apartment Condo Other
Do you: Own Rent
If renting, do you have your
landlord’s permission to have a dog?
Yes No
Landlords or HOA Assoc. Name
& Phone Number (REQUIRED if you RENT):
How long have you lived at
this address?
If you are in an Apt or Condo,
what is the pet weight limit?
Will the dog be an indoor or
outdoor pet? Inside
Outside Both
How many hours will this dog
be inside?
How many hours will this dog
be outside?
How long will the dog be left
alone each day?
Where will the dog be left
when alone:
Will the dog be allowed on the
furniture? Yes
No
Will some furniture be off
limits? Yes No
What will be off limits?
Will the dog be allowed in all
areas of the house? Yes No
Which areas will be off
limits?
Where will the dog sleep at
night? Dog House Outside Dog Bed
Inside Home Crate Inside Home Bedroom Garage Other
If other, please describe:
What brand of dog food will
you feed your dog?
Will you give your dog people
food? Yes No
What type of exercise will you
provide?:
Will you walk/exercise this
dog on or off leash (or both)?:
If off leash, where?
Do you have a backyard? Yes No
Is your backyard fenced?
Yes No
Height of fence: Type of fence:
Latched Gates?
Locked Gates?
Do you have a pool? Yes No If yes, is it fenced? Yes No
Will this be your first dog?
Yes No
Please list any pets that you
currently have in your household:
Are ALL other pets spayed or
neutered? Yes No
If you have cats, are they
indoor or outdoor? Indoor
Outdoor
If you have a cat/s are they
de-clawed? Yes No
If the cat/s are de-clawed,
please explain why:
Please list pets you currently
have and have had in the past:
Pet #1 Breed
Male or Female
Length of Ownership?
Still own?
If yes, how old is this pet?
If no, what happened to this pet?
Pet #2 Breed
Male or Female
Length of Ownership?
Still own?
If yes, how old is this pet?
If no, what happened to this pet?
Pet #3 Breed
Male or Female
Length of Ownership?
Still own?
If yes, how old is this pet?
If no, what happened to this pet?
Have you ever been in a
situation where you were not able to keep a pet? Yes No
If you have given a pet away
before, please explain:
Were you ever in a situation
where you had to bring a dog to a shelter? Please explain:
Do you travel often? If so,
who will take care of the dog when you go out of town?
Who is your Veterinarian?
Address:
City: Zip:
Phone:
What is a reasonable amount to
spend if your dog became very sick?
Does anyone in the home have
animal related allergies? Yes No
If yes, who and to what?
How will you train this dog?
Are you willing to housebreak
a dog? If yes, using what method?
What will you do if the dog
has accidents in your house?
Do you understand and accept
that a change in a dog's environment may cause the dog to have accidents,
especially in the early days of the adoption? Yes No
What will you do if the dog
chews, digs, or has other bad habits?
Do you plan to take your new
dog to obedience school? Yes
No
If you answered no, please
explain why:
Are you prepared and able to
take care of this dog for his/her entire lifetime? Yes No
Do you have a friend or
relative who would take this dog if you became unable to care for it? If yes,
please list name and phone number
Please estimate the annual
cost of dog food, toys, vet care, grooming, etc. for your new pet
We are a 100% volunteer run
organization; the adoption donation is used to partially recover the costs
involved in rescuing the animal you are interested in. These costs include but
are not limited to: Animal Shelter Fees, Spay/Neuter, Food, Housing,
Vaccinations, De-worming, and any Veterinary Exams, or medical care that the
animal may have required. We would not have been able to save the life of the
animal you applied to adopt without the adoption donation from another that came
before him/her.
Are you willing and able to
make a minimum adoption donation as discussed? Yes No
If you answered No to the
above question please explain:
What circumstances would cause
you to give up a pet?
If you were unable to keep
this dog, would you return it to the Pomeranian Rescue Group as required by our
adoption contract?: Yes No
We reserve the right to
inspect all potential homes and yards prior to placement:
Is this agreeable
to you?: Yes No
I have read the above
information carefully and have filled out this application honestly. I
understand that an omission of information and/or failure to answer all
questions can result in the application being declined. Also, if an omission or
untruth is discovered after and adoption takes place, I understand and accept
that Pomeranian Rescue Group has the right to annul the adoption and reclaim the
dog. This application becomes a part of our Adoption Contract.
Agree Disagree