Forget-Me-Not Peke Rescue (FMNPR)

Adoption and/or Volunteer Application

Last Name:
First and Middle Names:
Home Street Address:
City
State:
Zip:
Home Phone Number:
Cell Phone Number:
Best Time and Phone for Us to Call:
FAX Number (if Any):
What Is Your Email Address? (If You Do Not Type In A Valid Email Address, We Will Not Be Able To Reply.) Please Make Sure Your Spam Blocker Will Not Prevent You from Getting Our Email. Check Your Junk Mail Folder for Emails from Us.
Name of Pet You Wish to Adopt, If You Have Chosen One:
Are You Familiar With The Characteristics of This Breed of Dog?
Are You Familiar With and Prepared For the Grooming Care and Upkeep Needs (As Often As Every 4 to 6 Weeks?)
Do You Have a Pool?	Yes    No
If You Have a Pool, Is It Fenced?	Yes    No    Not Applicable
Are You at Least 18? We Do Not Adopt to Individuals Under The Age of 18.	Yes    No
Please Tell Us Your Reason For Wanting This Pet.
Do You Prefer a Male or a Female?	Male    Female
Do You Want a Puppy, Young Dog, Adult, or Senior?	Puppy    Young    Adult    Senior
Does Anybody Living in Your Home NOT Want the Pet?
Do You Want a Pure-Bred, a Part-Bred, or Any Mix?	Pure-Bred    Part-Bred    Any
How Did You Hear About Us?
What Questions Do You Have For Us?
Please List Your Current Pet(s) Names, Breed, Sex, and Age:
Are There Any Children Under the Age of Five Either Living in the Home or Frequently Visiting?
How Many Adults Are In Your Home?	One    Two    Three    More
Will the Pet Be a Gift, and If So, For Whom:
Do You Agree to a Home Check Visit?	Yes    No
Do You Own or Rent Your Home?	Own    Rent
If You Rent Your Home, What is Your Landlord′s Name and Phone Number?
Do You Have a Fenced Yard?	No    Yes
What is Your Vet′s Name, Clinic Name, City, and Phone No. (or Previous Vet′s if You Have No Pets Now):
Please Give Two Non-Family Character References.    Your First Reference (Name and Phone No.):
Your Second Reference (Name and Phone No.):
How Many Miles Are You Willing to Travel to Pick Up the Dog?
Would Re-House-Training Of The Dog Cause You A Problem Or Frustration? We Cannot Guarantee House-Breaking Habits of Rescue Dogs.
What Methods Would You Use To House-Train Your Dog?
Will You Crate Train Your Dog?
Would You Be Interested In A Special Needs Dog?
How Would You Exercise Your Dog?
Have You Ever Adopted A Rescued Pet Before?	Yes    No
Will You Be Patient With Possible Irritable Behavior Of A Rescue Dog In A New Environment? Re-Homing Can Be Very Stressful To Any Adopted Animal.	Yes    No
Have You Ever Sold, Released Or Relinquished Any Pet To An Animal Shelter Or Rescue Group In The Past?
Please Describe Your Rescue Experience:
Please Remember That The Purpose of Rescue Is To Find A PERMANENT FOREVER HOME For These Dogs. Please Click The SUBMIT Button When Finished Filling Out This Form. (SUBMIT Will Email Your Application to Us and Return You to our Homepage.)