PLEASE READ BEFORE YOU SUBMIT YOUR APPLICATION!

  • This Application is for INDIANA residents ONLY!
    If you reside in Kentucky, please submit a Kentucky Application. 
    If you are outside of the states of Kentucky and Indiana, please
    visit our Rescue Links to locate a rescue in your area, or visit
    www.petfinder.org.  Thank you!
  • KPR will not adopt to anyone with unaltered pets.
    If you have any dogs in your household that are not spayed or neutered, please do not submit an application. We have very strong feelings about the pet overpopulation and feel that all pets should be spayed and neutered. Thank you!
  • Adoption Donations are NOT negotiable.
    We understand that you may not agree, but we ask that you respect our policies.  Please understand that we spend much more on medical bills than we recover in adoption donations for most of the Pugs we rescue, especially our senior Pugs.
  • Our Pugs do not come with a guarantee of physical condition.  All of our rescued Pugs are spayed/neutered, up-to-date on routine vaccinations, fecal tested and heartworm negative prior to placement.  Although we do provide the medical treatment and testing listed above, please remember that our Pugs are rescues and therefore we have no way of guaranteeing that they will not have medical issues in the future.
 
 
When filling out the application below, use the TAB key to navigate from question to question.

Do NOT use the ENTER key.  Pressing the enter key will submit your application before you have completed. 

When you are finished and click on the Submit button, your application is emailed directly to KPR. 
If it was submitted successfully, you will see "Your Adoption Application has been submitted successfully."

If you have problems submitting the application, please feel free to email webmaster@kentuckianapugs.com . Thank you!

INDIANA RESIDENT ONLINE ADOPTION APPLICATION

Family Information

 

Full Name

Street Address / Mailing Address

City / State / Zip

Daytime Phone (with Area Code)

Evening Phone (with Area Code)

Email Address
*Please make sure that this email address is one that you check regularly. Our initial contact with you will be via email.  You may want to check your junk mail folder, in case the unfamiliar address gets sent to your junk mail.  If you have not heard from us within two weeks, please contact us.*

Adults in Household and their ages

Children in Household and their ages

Occupation of Adults

Are there likely to be any major lifestyle changes in the near future?
If any, please list. Examples:  moving, expecting a child, caring for an elderly relative in your home, etc.

Is there a member of your Household who doesn't want a Pug or dislikes dogs?
 
  Yes
  No
 

Information About Your Residence


Type of dwelling?
 
House
Apartment/Townhouse
Mobile Home

Do you own or rent?
 
Own
Rent

If you Rent, please provide the Apartment Complex Name (if applicable),
your Landlord's name and phone number.

What area do you live in?
 
City
Suburbs
Rural/Country

How long have you lived at your present address?
 

Approximately how large is your yard?
 

Is your yard fenced?
 
Yes
No

If Yes, what type of fence and how tall?
 

If No, do you plan on adding a fence for your Pug?
 
Yes
No

If you have no fence and no plans to add one, how will you ensure that your
Pug will get adequate exercise and play time outside?
 

Do you have a pool or a hot tub?
 
Yes
No

If Yes, is the pool or hot tub securely fenced in so that the Pug will not have access to it?
 
Yes
No
Will your pug have to climb any stairs over 1 inch in your home?
 
Yes
No

Does your home have air conditioning?
 
Yes
No

Where will your Pug sleep at night?
 

Do you plan to use a crate for your Pug to stay in when you aren't at home? 
Please explain why or why not.
 

Do you plan on keeping your Pug mainly indoors or outdoors?  Please explain.
 

 

Information About Current Pets


Please list all current pets, including - name of pet, type of pet, breed, age, sex,
spayed/neutered status
,  and if they stay indoors or outdoors. 
If your pet is not  spayed/neutered, please give the reason.  Thank you!
 

Do you own cats? If yes, are they declawed?
 

Where did you get your current pets? Ex - newspaper ad, breeder, animal shelter, etc.
 

If you have dogs, are you involved in any activities with them?  If Yes, what type of activities?
 

If you have dogs/cats - What type of heartworm preventative are they on?
 

If you have dogs/cats - What type of flea control do you use?
 

If you have dogs/cats - What type of food do you feed?
 

When you are not at home, where do your dogs stay?
 
Yard
Garage
Crate
Confined to certain area of house
Free run of house
Indoors with dog door

Do you consider your current pet(s) to be aggressive towards people or other animals? 
If yes, please explain.
 

 

Past History with Pets


Please list all past pets, including - type of pet, breed, amount of time owned, 
where kept, spay/neuter status, and where the pet is now and explanation.
 

Have you ever owned a Pug?
 
Yes
No

If Yes, where did you get your Pug?
 

If you have ever had to give up a pet, please explain.
 

 

Veterinary Information


Please list the Name, Address and Telephone Number of your current veterinarian. 
If you have no current pets, please list the information for your most recent veterinarian. 
Your application will not be processed without this information.

You will also need to let your Vet know that Kentuckiana Pug Rescue will be contacting them and give your Vet authorization to release information to KPR.

 

 

General Pug Information


Are you aware of the health problems that Pugs can have?
 
Yes
No

Please list the health problem you are aware of.
 

Are you willing to take care of any health problems that may occur after adoption of your Pug?
 
Yes
No

Do you know that Pugs shed 365 days a year?
 
Yes
No

Do you know Pugs snore?
 
Yes
No

Pugs can live to be 14+ years old. 
Are you willing to have a Pug be a part of your life for that amount of time?
 
Yes
No

What types of behaviors do you expect from your Pug?
 

What amount of time and effort do you plan to devote to your Pug each week?
 
3 - 4 hours
5 - 7 hours
7 - 10 hours
10 plus hours

Do you plan to enroll your Pug in obedience class?
 
Yes
No

What family members will assist in potty training, exercising and feeding the Pug?
 

What is your definition of disciplining a dog?
 

Do you have any training objectives for your Pug?
 

 

Type of Pug you would like to adopt?


What color Pug do you which to adopt?
Fawn
Black
No Preference

What age preference do you have for your Pug?
Less than 1 year old (very rare in rescue)
1 - 6 years old
6 years plus
No Preference

What sex do you prefer to adopt?
Male
Female
No Preference

Would you adopt a Pug mix?
Yes
No

Would you adopt a bonded pair of Pugs that have been together their entire lives?
Yes
No
 

Are you willing to financially care for your Pug's health throughout his/her lifetime?
Yes
No

Are you willing to have a home visit and interview?
Yes
No

Are you willing to return your Pug to Kentuckiana Pug Rescue should
any problems arise that force you to no longer care for your Pug?
Yes
No

Is this Pug for someone else?
Yes
No
 
Would you be willing to adopt a special needs Pug?
Yes
No
 

If Yes, please state which special needs you would be willing to accept.
(Blindness, Deafness, Lameness, On medication full time)
 

Please give any additional information you feel would be helpful to Kentuckiana Pug Rescue?

 

References


Please list the Names, Addresses and Phone Numbers of 3 References. 
(Important: At least 2 of these can NOT be relatives.)

Reference # 1

Reference # 2

Reference # 3

How did you learn about Kentuckiana Pug Rescue?
(internet search, friend, veterinarian, etc.)

What is the best method for us to contact you? (Text, Phone or Email)

 

 

Kentuckiana Pug Rescue PO Box 2773 Indianapolis, IN 46206 webmaster@kentuckianapugs.com 877-784-7988