Foster Application

Your General Information

First Name*

Middle Name

Last Name*

Street Address 1*

Street Address 2

City*

State*

Zip*

Email Address*

Home Phone Number*

Work Phone Number

Cell Phone Number

Occupation/Profession*

Employed by (Name/City)*

Hours worked per day*

Spouse / Partner / Roommate

First Name

Middle Name

Last Name

Work Phone Number

Cell Phone Number

Occupation/Profession

Employed by (Name/City)

Hours worked per day

Other adults and children (ages) living in home

Questions

Why do you want to foster a pug? 001

As the main person filling out this application, are you the primary care person? 002

YesNo

Are you physically able to take care of the pug? 003

YesNo

Are you able to lift a 20 pound animal? 004

YesNo

Are you a United States Citizen? 005

YesNo

Are you a year round CA resident? 006

YesNo

Does anyone in the home smoke? 007

YesNo

Do you have changing roommates? 008

YesNo

Do you want a pug to give as a gift? 009

YesNo

Is anyone in the home terminally ill? 010

YesNo

Do you rent or own? 011

RentOwn

What type of residence do you live in (ie. house, condo, apartment, mobile home, etc.)? 012

Do you live on/near open water? 013

YesNo

Is anyone in home (over 18) not able to take care of the pug? 014

YesNo

Have any of the applicants ever been cited or fined for animal related situations? 015

YesNo

Have you been denied adoption from another rescue group or shelter? 016

YesNo

Is anyone in your household allergic to dogs? 017

YesNo

Does anyone in the home not want the pug? 018

YesNo

If Yes, explain.

Do you travel on business? 019

YesNo

If Yes, how often?

Do you travel for pleasure? 020

YesNo

If Yes, how often?

Do your animals travel with you? 021

YesNo

If Yes, how often?

Does anyone in your family work from home? 022

YesNo

Is anyone in the home subject to transfer? 023

YesNo

If Yes, how often?

Will you have any major lifestyle changes in the near future? (ie. expecting child, moving, etc.) 024

YesNo

If Yes, explain.

Have you ever owned a pug before? 025

YesNo

Have you ever lived with a pug before? 026

YesNo

Have you ever lived with a dog before? 027

YesNo

Do you currently own a dog? 028

YesNo

If Yes, how many?

Describe each.

1	Breed
	Age
	Character	ActiveMellowAlphaDon't have one.
	Gender	MFDon't have one.

2	Breed
	Age
	Character	ActiveMellowAlphaDon't have one.
	Gender	MFDon't have one.

3	Breed
	Age
	Character	ActiveMellowAlphaDon't have one.
	Gender	MFDon't have one.

4	Breed
	Age
	Character	ActiveMellowAlphaDon't have one.
	Gender	MFDon't have one.

Do any of your dogs have any physical problems?

Do any of your dogs have dominance problems?

Do any of your dogs not get along with other dogs?

Have you ever had an animal euthanized? 029

YesNo

If Yes, explain.

Do you have a cat or cats? 030

YesNo

If Yes, how many?

Are they dog friendly?

YesNoN/A

Have you ever lost an animal? 031

YesNo

If Yes, was the animal found?

YesNoNever lost

Have you ever taken an animal to a shelter or released an animal to another party? 032

YesNo

If Yes, explain.

Have you ever bred animals for pleasure or profit? 033

YesNo

Are you familiar with the animal control regulations in your area? 034

YesNo

Are all of your current household animals spayed or neutered? 035

YesNo

Are all of your household animals current on vaccinations? 036

YesNo

What type of pug do you prefer? Check all that apply. 037

FawnBlackBrindleNo Color PreferenceMaleFemaleNo Gender Preference1-4 yr5-8 yr9+ yrNo Age PreferenceSpecial Needs

Would you foster a special needs pug? 038

YesNo

If open to special needs, please check which special need(s) you would accept. Check all that apply.

BlindDeafDiabeticEpilepticArthritisAllergiesDaily MedicationsIncontinentCan't climb stairsBack Problems

Are you open to fostering a pug mix? 039

YesNo

Is there anything else specific you are looking for in a pug? 040

Are you able to take the pug to the vet? 041

YesNo

Are you willing to meet with prospective adopters? 042

YesNo

Can you deal with a pug that snores? 043

YesNo

Can you deal with a pug that scratches to communicate? 044

YesNo

Can you deal with a pug that may bark? 045

YesNo

Can you deal with a pug that has accidents or may become incontinent? 046

YesNo

Can you deal with a pug that licks? 047

YesNo

Can you deal with a pug that sheds a lot? 048

YesNo

Are you willing to house train a new pug? 049

YesNo

Are you willing to trim the nails or have the pugs nails trimmed on a regular basis? 050

YesNo

Are you willing to administer daily eye drops or medicine to the pug if needed? 051

YesNo

Are you willing to have the pugs anal gland expressed periodically if needed? 052

YesNo

Have you ever housebroken a dog before? 053

YesNo

Did you use a crate? 054

YesNo

Will the pug be restricted from/to certain room(s)? 055

YesNo

If Yes, explain.

Will the pug be restricted from the furniture? 056

YesNo

Where will the pug sleep at night? 057

Where do other animals sleep? 058

How many hours a day, on average, will your pug be alone? 059

Where will you keep your pug when you are away from home during the day? 060

While you are out, will the pug have access to a doggy door and the outdoors? 061

YesNo

Where will your pug stay when you are out of town? 062

If the pug has an accident in the house, explain what you would do? 063

Do you agree to keep a current ID tag on your pug at all times? 064

YesNo

Do you agree to keep your pug current on all shots and on heartworm preventative? 065

YesNo

Can you commit to care for the pug for its whole life, even if special needs arise? 066

YesNo

What would you do if your pug became a special needs pug? 067

Do you have and use air conditioning? 068

YesNo

Do you have a pool or spa? 069

YesNo

If Yes, is the pool covered or fenced?

YesNoN/A

Do you have a backyard? 070

YesNo

If Yes, is it fenced?

YesNoN/A

Do you have a fenced front yard? 071

YesNo

Do you have a fenced patio? 072

YesNo

How tall are your fences in front yard &/or backyard? 073

Do you have a gate to the backyard? 074

YesNoN/A

If utility meters are located in backyard area, will meter readers be entering this area? 075

YesNoN/A

Will gardeners or pool maintenance people be entering the back area? 076

YesNo

Are you willing to put a padlock on the back area gate? 077

YesNo

Do you have a balcony or deck? 078

YesNo

If Yes, what is the space between rails (inches)?

Do you have stairs? 079

YesNo

If Yes, do you have stairs inside, outside or both?

InsideOutsideBoth Inside and OutsideN/A

If you have stairs, are any stairs open backed?

YesNoN/A

Will you reinforce or enclose areas if we request? 080

YesNo

Are all windows screened? 081

YesNo

Do you have a doggy door? 082

YesNo

If No, are you planning to get a doggy door?

YesNoI already have a doggy door.

Pesticides, slug/snail pellets and other chemicals such as antifreeze are toxic. Do you agree not to use any of these in areas your pug will have access to? 083

YesNo

Does your homeowners association, apartment, or mobil home, condominium, etc. allow pets? 084

YesNoN/A

If Yes, explain restrictions.

If you rent, do you have permission to own a dog? 085

YesNoN/A

Your Landlord's Information:

Name:
Phone:

If your pug had an emergency or serious illness, how much would you be willing to spend on vet bills? 086

$100$250$500$1000Whatever it takes

Under what circumstances would you justify getting rid of a pug? 087

Are you willing to help PRNC at their functions? 088

YesNo

Would you object to a representative of PRNC calling to check on how you & pug are doing? 089

YesNo

Would you object to a home visit by a representative of PRNC? 090

YesNo

If Yes, why?

Are you willing to return the pug to PRNC should unforeseen circumstances arise? 091

YesNo

Do you authorize your veterinarian to give PRNC a reference? 092

YesNo

If Yes.

Current Vet:
Phone:

How did you find out about PRNC? 093

Is there anything else you think we should know about you, your pets or your family? 094

Terms of Agreement

Thank you for taking the time and care to complete this application. Please try to answer each question as completely as possible. Incomplete applications may not be considered. By clicking “SUBMIT THE APPLICATION” button below, you are attesting to the truthfulness of your answers.

PUG RESCUE OF NORTHERN CALIFORNIA RESERVES THE RIGHT TO REFUSE ANY APPLICATION.

Furthermore, by submitting this application you are attesting to have read and are able and willing to follow our Foster Guidelines as listed below:

Foster parents agree to give loving care to the rescued pug(s) and provide a safe, indoor environment. Pugs shall be kept in the house at all times with the exception of being taken outside to go to the bathroom. At no time shall the dog(s) be tied to any object outside, nor shall they be kept in any outdoor kennel.
Foster parents agree to only take foster pugs to authorized veterinarians, except in cases of extreme emergency. Pug Rescue of Northern California will pay for all medical care by such veterinarians.
The foster parent understands that it may be necessary to drive the dog to the veterinarian, to meet with prospective adoptive families and other places, and is willing to do so.
Foster parent agrees to feed the pug(s) premium dog food, and agrees to feed, water and exercise the dog appropriately. This includes no unsupervised, off-lead time.
Foster parent understands that often a pug comes into rescue needing medication. Pug Rescue of Northern California will pay for all medications necessary for the dog(s). The foster parent agrees to administer the medication(s) to the dog in accordance with the veterinarian instructions.
A rescue pug often comes in on short notice with no indication of health or temperament. Foster homes have to be willing to help assess this and be willing to update the Pug Rescue of Northern California Coordinator on a weekly basis. Pug Rescue of Northern California cannot guarantee foster pugs will be potty trained on arrival.

I HAVE READ AND AGREE TO ALL OF THE TERMS ABOVE.