Adoption Application — Wichita Pug Rescue, Inc.

Personal Information

First Name *

Last Name *

Email Address *

Use the email you check most often.

Phone Number *

Street Address *

City *

State *

ZIP *

Dog of Interest

Which dog are you interested in adopting? *

Home Environment

Type of Home *

Do you own or rent? *

If renting, does your landlord allow pets?

Do you have a yard? *

If fenced, what type of fence?

Number of adults in household *

Ages of children in household (if any)

Current & Past Pets

Do you currently have other pets? *

If yes, please describe your current pets (breed, age, sex, spayed/neutered)

Please list past pets and what happened to them *

A good veterinarian reference for past pets is required to adopt from us.

Veterinarian Reference

You must have kept past pets up to date on all vaccines (rabies, distemper/parvo at minimum). No exceptions.

Veterinarian / Clinic Name *

Veterinarian Phone *

Daily Care & Lifestyle

How many hours per day will the dog be left alone? *

Where will the dog stay when you are away? *

How do you plan to exercise the dog? *

About You

Why do you want to adopt a pug, and why are you the right home? *

I have read and agree to the adoption rules. I understand that once approved by email, I have 24 hours to respond or my approval will be cancelled. I understand that Wichita Pug Rescue does not promise or save dogs verbally — approval requires a completed application. *