Mid-Michigan Pug Club

Mid-Michigan PUG Club Rescue Program Adoption Application

PO Box 333
Belmont, Mi 49306

www.midmichiganpugclub.com
Gwynne Turner - adoptapug@yahoo.com

Please include, with your application, a donation of $3.00 payable to MMPC. This fee covers the cost of postage, envelopes and stationary for correspondence with regard to your application.

NOTE: The purpose of this application is not to make adopting a pug difficult, but rather to ensure that the right person is chosen for the right pug. We invest so much time, energy, money and love into rehabilitating pugs that we feel very strongly about being completely thorough with our applications. Thank you for your understanding.

Please print and answer each questions completely. If a question does not apply to you, indicate so.

First Name	Last Name
Address 1
Address 2
City	State Zip
Country
Phone Home	Work Cell
Email
How did you find us?
Housing	Own Rent Other Describe If renting please send copy of lease agreement showing pets allowed.
Fenced-in Yard?	Yes No
Water Features	None Pool Pond or Lake
How long have you lived at current residence?	Years Months
Planning to move in next 6 Months?	Yes No
What will you do with the pug if you do move?
How many people will be living in the home with pug?	Please list the number of adults and children, with the ages of the children.
Does everyone in the family agree to having the pug?	Yes No
Would you agree to a home visit?	Yes No
Does anyone have any allergies to dog hair?	Yes No
Does anyone have a problem with snoring?	Yes No
List the other pets that will be living in the home with pug?	Species Breed Sex (Altered) Age How long owned (Indoor/Outdoor)
List the other pets that you have had in the last 5 years.	List pets and what happened to them. Please be specific.
Have you ever given a pet to a shelter or someone else?	Yes No Details
Have you been convicted or accused of animal cruelty or abuse?	Yes No Details
What if the PUG does not get along with other animals present in home?
Veterinarian's Name
Vet's Address
Vet's City	Vet's State Vet's Zip
Vet's Phone
Will you keep the pug indoors?	Yes No
Will you use heartworm preventative medication?	Yes No What brand?
How long of an adjustment period will you allow?	Years Months Weeks
How will you correct the pug?	Please be specific.
How will you confine pug when you aren't home?	Crate Room Yard Other Details
How much time each day will the pug be alone?	Hours Minutes
Will you leash train the pug?	Yes No
What will you do if the pug is lost?	Please be specific.
Do you realize pugs over heat easily?	Yes No
Is your home arranged to keep a curious pug from getting into poisons or other dangers?	Yes No
How would you react if a pug chewed a personal item?	Please be specific.
What eye care will your pug receive?	Please be specific.
How much per year will you be willing to spend on your pug's health care?	$
What will you feed your pug?	Please be specific.
Do you realize a PUG, like a child, is a lifelong commitment and not a passing whim?	Yes No
Why do you want a pug?	Please be specific.
Please indicate which of these you might have experience with along with details.	Male dogs Details: Female dogs Details: Fearful dogs Details: Aggressive dogs Details: Training dogs Details: Animal Medicine Details:
Please select preferences for your choice of pug.
Age	Under 1 year 1 to 4 years 5 to 9 years No preference
Color	Fawn Black No preference
Gender	Male Female No preference
Would you accept a handicapped or disabled pug	Yes No
List three personal references with phone numbers. All will be contacted.	Name Phone Name Phone Name Phone

When completed form will be emailed to Gwynne Turner, adoptapug@yahoo.com when submit button is pushed. The form can also be mailed to:
Mid-Michigan Pug Club, Inc., For the Love of Pugs
P.O. Box 333
Belmont, MI 49306

If you have any questions, please feel free to contact Gwynne Turner by email adoptapug@yahoo.com . If you are approved, and a PUG is placed with you, please be aware that you will be contacted periodically to assess how you and your PUG are adjusting to each other and to help with any problems you may be experiencing. Please also note that you will be required to sign a legal, binding, adoption contract before you receive your PUG.

A small donation of as little as $3.00 would greatly help with the costs of our office supplies to continue our work with the puggies. $30. would pay for an office visit to the veterinarian. Anything you can do to help is appreciated. Checks can made out to MMPC. Thank you for your generosity.