So Cal Chiweenie Rescue
Adoption Application 
Please cut and paste this into a word or text document or email, complete it, and email back to us.
Note - it is not our intention to invade your privacy, but merely to be sure that the dog you select is the best fit for your family.

Date: ________________
Name: ________________________________________________
E-mail Address: ________________________________________
Address: ______________________________________________
_______________________________________________________
Home Phone #: (_______)______________________
Work#(_______)______________________________
Cell #(_______)_______________________________
Name of the dog(s) you are interested in: _________________________
If you don’t see a specific dog you like, we will do our best to match your request with new arrivals.
Are there any breeds you prefer? ____________________ Are mixes ok? ____________
What age of a dog would you like to adopt? ____________________________________
Would you like to adopt a male or a female? (note that all dogs will be altered) ________
Do you have any personality preferences? (high energy, low key, good with kids, etc…) ________________________________________________________________________
Who lives in the household. Ages of children, number of adults.
________________________________________________________________________
Do other kids visit your home on regular basis? ________________________________
Who will be responsible for the care of the dog? ________________________________
Do you rent or own your residence? _________________
If rent, please provide landlord phone number: __________________________________
Do you have a yard? (a yard is not a requirement for most dogs) ____________________
Is your yard fenced? ________ How high? ________________________________
Do you have a pool? ___________________
Does anyone in your home have pet allergies? __________________________________ 
Where will the dog primarily stay (house, yard, kennel, a room, etc)? ________________
________________________________________________________________________
Where will the dog sleep at night (crate, doghouse, owners’ bed, couch, own bed, etc…? ________________________________________________________________________
On average how many hours a day will the dog be left alone? _____________________
Where would the dog stay while alone (house, kennel, yard, etc…)?_________________ ________________________________________________________________________
Current pets:
| Type/breed | Age | Sex | Inside/outside? | How long owned?
1) | | | | |
2) | | | | |
3) | | | | |
4) | | | | |
What is the name and phone number of your current veterinarian? _______________________________________________ ________________________
Previous pets:
| Type/breed | How long owned? | What happened to the pet?
1) | | |
2) | | |
3) | | |
Have you ever had to give up an animal for any reason? ________
If so, what was the reason? _________________________________________________
What would happen to this pet if you were to move? _____________________________
Are you planning on taking this dog to obedience classes? _________________________
Would you object to a home visit by one of the volunteers? ________________________
Is there anything you would like to add? 
________________________________________________________________________