Pekingese Rescue Network, Inc. (PRNI)
ADOPTION APPLICATION FORM
What is the name of the dog you want to adopt?
Do you want to adopt, foster, or volunteer in other ways?
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Your Full Name
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First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Your best contact phone number
Format: (000) 000-0000.
Your Address
*
Street Address
Street Address Line 2 (optional)
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
How old are you?
*
(age in years)
Driver's License No. and State
*
Please list the other adults in your home, their relationship, and their ages.
*
Please list ages of children in home and whether they live with you full-time or part-time. Do other children visit? How old are they?
Your employer's name and their best phone number.
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Why do you want a Pekingese dog?
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Where would the Pekingese be kept when you are away from home or sleeping? How long would they be alone?
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Do you have a preference for male or female Pekingese? Males are more likely to be available.
Male
Female
Either is OK
How old a Pekingese do you prefer?
Under one year
Between one and 10 years
Over 10 years
Age doesn't matter
What do you expect the annual cost of caring for a Pekingese to be (vet care, feeding)?
*
Do you own or rent your home? If you rent, you will have to provide proof that you are authorized to have a pet there.
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Own
Rent
If you rent, please provide your landlord's name and phone number.
What type of building do you live in?
Do you have a fenced yard?
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If so, what type, material, and height? If you don't have a fence, how would you keep your dog in your yard?
How many steps are there in various areas in your home? Please describe.
Who will train, feed and exercise the Pekingese?
What problems would make you return a Pekingese?
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If your Pekingese has a behavior problem, are you willing to crate-train it or take it to training classes?
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Yes
No
Please list and describe all pets you have owned, particularly DOGS you have now.
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If you have dogs now, what are their breed, age, sex, weight, and personality? Are they friendly to other dogs?
If you no longer have these pets, please explain why.
Please provide your veterinarian's name and phone number so we can verify your pets have received regular vet care. Please tell their office people to expect our call.
*
Please provide an adult reference's name and phone number (not a family member).
*
Please provide a second adult reference's name and phone number (not a family member).
*
How would you like to volunteer? Pick up dogs at shelters? Take dogs to vet? Groom dogs? Help with fund-raising? Photography? Post dogs on adoption websites? Other ideas?
FINISHING UP
Please scroll all the way down to finish this form as follows: 1. Read our adoption policy. 2. Check the box "I'm not a robot" 3. Click the SUBMIT button. Jotform will email your application to us and send a copy to you as well. 4. Separately email digital photos of your home and yard, particularly showing where the dog will be kept, to: CODOAN@AOL.COM You may also choose either to print the form first or to save your draft to finish later. If you choose to finish it later, Jotform will email you a link to your draft. Thank you for filling out our Pekingese adoption application!
OUR ADOPTION POLICY
If at any time the adopter cannot keep the animal, it must be returned to Pekingese Rescue Network, Inc. In addition, each pet adoption is assessed a donation, varying by animal, to help pay veterinary and other expenses. Adoption donations are non-refundable. Adoption donations must be given in advance to place a dog on hold. If for any reason you should decide you no longer wish to adopt the dog that has been held for you, the donation fee will not be refunded.
Please verify that you are human
*
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