Southern California Pomeranian Rescue
About Pomeranians
Thinking About Adoption

Adopting:

Adopting is a very short process. We would have you fill out an application and submit it.
After that we reserve the right to come and inspect your home to ensure that it is "puppy-proof" and that there are no
hidden dangers for them to get into. Often people do not realize that common household plants, electronics set ups,
unstable furniture, unenclosed balconies, pools, and other unsuspecting areas can pose a menacing threat. Avocado trees, aloe vera plants, and others can be poisonous. Unsecured balconies and high beds pose a threat of broken limbs, and so on. After the inspection the dog/puppy will be brought to your home for an initial meeting, if all goes well we will leave the animal with you and take the donation back to the rescue to help others. Our standard adoption fee ranges between $100-500 based on what we and the shelters have provided it with.
The common costs incurred are worming, vaccines, microchips (all dogs leave with one), spay/neuter, transport expenses,
and medications to treat pre-existing conditions. If you are unsure of being able to afford this fee, we can always arrange
for you to foster the dog you like with the added benefit of being able to pay the donation when you adopt down the line.
During a foster situation with the intent to adopt the foster dog, we will place the dog on a hold status until you can afford
the adoption fee.

Please read the following application carefully and when you are ready to adopt fill it out and return it to us by email or fax.

_______________________________________________________________________________________



Southern California Pomeranian Rescue Group

Krystal Morris, CFO

1122 E Lincoln Ave #B200, Orange CA 92865

ADOPTION APPLICATION

Completion of this application does not guarantee adoption of pet.

Date:_____________ Desired dog/cat:________________________

Name of Applicant: __________________________ Occupation:__________________

Age_________________________

Spouse/Significant other:______________________ Occupation:__________________Age____________________________

Names & Ages of Children, if any:______________________________________________

Any other occupants in home:_________________________________________________

Home Address/

/City /zip:____________________________________________________________________

HOME: [ ]_______________ WORK:[ ]________________ MOBILE:_________________

EMAIL:__________________________________________________

1. Type of dwelling: House_____ Condo____ Apt._____ Other:_____

Do you own?___ Rent?____If renting, do you have permission from landlord to have a dog? Y___ N___ Landlords name & #________________________________________

What are you primary reasons for wanting a dog/cat? Companion____ for your children_____ Gift_____For other pet_____ Watchdog_____ OTHER________________________________________

If you have children, please describe their previous experience with dogs/cats:______________________

5. If your children did not want a dog/cat, would you be interested in adopting one for yourself?

Y____ N____

If your present relationship were to change, who would the dog/cat go to? _________________

Does anyone in your household have allergies? Y___ N___ Describe_________________________

8. Other pets [number, sex & age of each] Dogs?________________________________________

Cats?_____________________ OTHER?____________________________________________

Are your pets spayed/neutered Y___ N___

Have you ever allowed an animal to breed? Y___ N___

11. Is there anybody home during the day?____________Who______________

12. When will the dog/cat be inside?______________ Outside?:_________

How many hours per day will the dog/cat be left alone?_____

Where will it be when left alone?________

14. Where will the dog/cat sleep at night? Dog house___ Garage___ Laundry room___ Kitchen_____Master bedroom______ Child’s room___ Bathroom_____ Other___[explain]__________________

15. What rooms are off limits to the dog/cat?___________________

What outside areas are available to the dog? Fenced yard___ Enclosed Patio___ Garage__________Balcony____ Dog House____ Unfenced common area____ Other___________

17. Do you have a doggie door? Y______ N_______

18. Type of fencing? Chain link____ Wood _____ Block wall____ Other__________

Height of fence: Highest point_______ Lowest point_______

Are their gates? _____ How many? ______ How high?_________

Have you recently inspected your fence and is it secure, without holes, gaps, or low points? Y_________N______. If NO, and your application is accepted, do you agree to thoroughly inspect your fence and make any necessary repairs before the home visit?

          Y_____ N_____

Is there any type of lock on the gate[s]? Padlock____ Key____ Latch____ Other_____

Do you have a pool?_______If yes, is there a secure fence around it?_________

Who has access to your yard? Gardner___Poolman___Housekeeper___Utility___Neighbor___

Preferred level of exercise with dog? Couch potato___ Short walks___Vigorous walkd___ Hike/jog___

26. When you go on vacation, who will care for the dog/cat?____________________________________

27. What kind of food will you feed the dog/cat? Brand of Kibble_____________Name:_______________

28. Do you have a regular VET? Y___ N____

VET NAME/#:________________________________

Who Will Groom And Bathe Your dog/cat?______________________

Would your dog/cat wear a collar? Y_______ N_________

Would you allow your dog/cat to wear a permanent RESCUE I.D. tag? Y______ N________

How would you rate your level of dog/cat owning experience? 1st time owner_____ Beginner_______ Intermediate__________ Advanced___________ OTHER_____________________________

33. How would you discipline your dog/cat if he or she misbehaved?

___________________________

How would you train this dog/cat? Obedience class___Hit with Newspaper___Firm verbal command____Clicker/hand signals_____ OTHER____________________

35. How do you normally walk you dog? On leash?_____ Off leash?____

36. When on Leash I normally use: Collar only____ Choke chain___ Harness____ Other___________

37. Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times? Y__________ N__________

38. Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter and exercise for your new pet? Y_______ N_________

Are you able to make a long-term commitment to care for your pet for his/her entire life span, which could be as much as 10-20 years? Y______N________

What would happen to you pets if you moved?

           Locally?_______________ Out of State?_____________Out of country?_____________

41. Are you planning on moving within the next 12 months? ___________________

Have you ever given a pet away? If so, please explain____________________

                    ____________________________

Which of the following reasons might prompt you to give up your dog/cat?

Excessive Barking_____Biting_____ Digging_____ Moving_____ Divorce_____

Poor watchdog______ Shedding____Destructive Chewing_____Financial problems____ Accidents indoors____ Growling at guests____Excessive Vet Bills____ Allergies____

New spouse/partner doesn’t like dog____ Aggressive on leash_____Illness______

NONE OF THE ABOVE_____

Will you agree to consult and pay for a trainer or behaviorist if any problems develop? Y___N___

Please list pets you have owned since you have been an adult:

ANIMAL LENGTH OF OWNERSHIP WHAT HAPPENED?

Pet 1:
Name
Age
Gender
Species/Breed
Still Own? If Not Why? _______________________________________

Pet 2:
Name
Age
Gender
Species/Breed
Still Own? If Not Why? _______________________________________

Pet 3:
Name
Age
Gender
Species/Breed
Still Own? If Not Why? _______________________________________

Pet 4:
Name
Age
Gender
Species/Breed
Still Own? If Not Why? _______________________________________

How did you find out about our adoption program?_________________________

Why are you interested in adopting from a rescue?_________________________________________

Please read and initial each statement below.

I understand that a home visit is required prior to final placement ___________ [initial]

I understand that a home visit does not guarantee placement ___________[initial]

I agree to provide my own collar, leash, choke chain or harness, and personal ID at the time of completing the adoption contract _______[initial]

I can_______ cannot_____ make a donation of at least $100.00-$500 for the dog to help cover costs of pet we are adopting, anything over that amount will help with medical care, spay and neuter, board and place other abandoned dogs. [Inability to make a donation does not disqualify an applicant from consideration] I understand that any donation or contribution is a gift freely given, not a purchase price for a dog

________ [initial]

I understand that my donation is non- refundable_______[initial]

SIGNATURE____________________________DATE:________________

ANY OTHER DEAL POINTS:

1.

2.

_____________ I reserve the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of our contract________[initial]

_______________[ INITIAL OF ADOPTER ] _____________[INITIAL OF RESCUER]

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